Provider Demographics
NPI:1528735073
Name:ROBERTS, REBEKKA (MA, TLMHC)
Entity type:Individual
Prefix:
First Name:REBEKKA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MA, TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 E AVE NW STE 105
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52405-2962
Mailing Address - Country:US
Mailing Address - Phone:131-948-3666
Mailing Address - Fax:
Practice Address - Street 1:3100 E AVE NW STE 105
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52405-2962
Practice Address - Country:US
Practice Address - Phone:800-531-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA108335101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health