Provider Demographics
NPI:1457615304
Name:CARBARY, REBECCA (MSW/LISW-S)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:CARBARY
Suffix:
Gender:F
Credentials:MSW/LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BENEDICT AVE STE 103B
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2112
Mailing Address - Country:US
Mailing Address - Phone:419-921-9825
Mailing Address - Fax:
Practice Address - Street 1:85 BENEDICT AVE STE 103B
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2112
Practice Address - Country:US
Practice Address - Phone:419-921-9825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2024-12-19
Deactivation Date:2023-07-06
Deactivation Code:
Reactivation Date:2023-08-16
Provider Licenses
StateLicense IDTaxonomies
OHI.14506541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical