Provider Demographics
NPI:1174140818
Name:MITCHELL, REBEKAH JANE (CADC)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:JANE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE FALLS
Mailing Address - State:ME
Mailing Address - Zip Code:04254-1529
Mailing Address - Country:US
Mailing Address - Phone:207-320-3305
Mailing Address - Fax:207-645-2372
Practice Address - Street 1:76 MAIN ST
Practice Address - Street 2:
Practice Address - City:LIVERMORE FALLS
Practice Address - State:ME
Practice Address - Zip Code:04254-1529
Practice Address - Country:US
Practice Address - Phone:207-320-3305
Practice Address - Fax:207-645-2372
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC6769101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)