| Rebecca Rand Counseling Llc | |
|
136 S Academy Ave Ste G Eagle ID 83616-6541 | |
| (208) 912-6621 | |
| (208) 939-9110 |
| Full Name | Rebecca Rand Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 136 S Academy Ave Ste G, Eagle, Idaho |
| Authorized Official Name and Position | Monica Mathis (BILLER) |
| Authorized Official Contact | 9542612935 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rebecca Rand Counseling Llc 2886 E Fern Brook Dr Eagle ID 83616-6602 Ph: (208) 912-6621 | Rebecca Rand Counseling Llc 136 S Academy Ave Ste G Eagle ID 83616-6541 Ph: (208) 912-6621 |
| NPI Number | 1013514728 |
|---|---|
| Provider Enumeration Date | 10/06/2020 |
| Last Update Date | 11/05/2020 |
| Certification Date | 11/05/2020 |
| Medicare PECOS PAC ID | 8123438918 |
|---|---|
| Medicare Enrollment ID | O20201105002773 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013514728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Rebecca L Rand |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487968996 PECOS PAC ID: 5597992024 Enrollment ID: I20201113000310 |
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