Provider Demographics
NPI:1891596102
Name:DEKKERS, REBECCA THERESA (LMFT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:THERESA
Last Name:DEKKERS
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8276 SCANDIA RD
Mailing Address - Street 2:
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-9629
Mailing Address - Country:US
Mailing Address - Phone:952-807-7853
Mailing Address - Fax:
Practice Address - Street 1:8276 SCANDIA RD
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-9629
Practice Address - Country:US
Practice Address - Phone:952-807-7853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4417101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health