Provider Demographics
NPI:1962277871
Name:MCCAUGHIN, REBECCA ANN RAINES
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANN RAINES
Last Name:MCCAUGHIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ELLSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1419
Mailing Address - Country:US
Mailing Address - Phone:518-339-4440
Mailing Address - Fax:518-439-0658
Practice Address - Street 1:28 ELLSWORTH AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1419
Practice Address - Country:US
Practice Address - Phone:518-339-4440
Practice Address - Fax:518-439-0658
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician