Provider Demographics
NPI:1528702982
Name:SCHADE, REBECCA ANN (LPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:SCHADE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:ANN
Other - Last Name:SCHADE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1712 W LOUGHLIN DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-1850
Mailing Address - Country:US
Mailing Address - Phone:602-509-5896
Mailing Address - Fax:
Practice Address - Street 1:1310 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5420
Practice Address - Country:US
Practice Address - Phone:480-649-3642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-20912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health