Provider Demographics
NPI:1891122883
Name:HUNKE, REBECCA C (LCMHC, LADC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:C
Last Name:HUNKE
Suffix:
Gender:F
Credentials:LCMHC, LADC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:C
Other - Last Name:GEROULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ADC
Mailing Address - Street 1:33 BLINN ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:NY
Mailing Address - Zip Code:12887-1602
Mailing Address - Country:US
Mailing Address - Phone:518-791-1608
Mailing Address - Fax:
Practice Address - Street 1:278 VT ROUTE 149
Practice Address - Street 2:
Practice Address - City:WEST PAWLET
Practice Address - State:VT
Practice Address - Zip Code:05775-9798
Practice Address - Country:US
Practice Address - Phone:802-645-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000606101YA0400X
VT151.0126818101YA0400X, 101YA0400X
VT068.0107640101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional