Provider Demographics
NPI:1972303519
Name:ALLEN, REBECCA NICOLE (LPCA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:NICOLE
Last Name:ALLEN
Suffix:
Gender:
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:WHITLEY CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42653-0368
Mailing Address - Country:US
Mailing Address - Phone:606-516-4665
Mailing Address - Fax:
Practice Address - Street 1:1011 N HIGHWAY 27 STE 8
Practice Address - Street 2:
Practice Address - City:WHITLEY CITY
Practice Address - State:KY
Practice Address - Zip Code:42653-5025
Practice Address - Country:US
Practice Address - Phone:606-516-4665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY287752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health