Provider Demographics
NPI:1417761180
Name:CARTER, REBECA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:CARTER
Suffix:
Gender:
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1297 CASCADE DR FL 33837
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-1605
Mailing Address - Country:US
Mailing Address - Phone:407-433-1837
Mailing Address - Fax:
Practice Address - Street 1:1297 CASCADE DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-1605
Practice Address - Country:US
Practice Address - Phone:407-433-1837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011199771041C0700X
FLSW243701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical