Provider Demographics
NPI:1457243008
Name:SMITH, REBECCA VIVIAN (LCSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:VIVIAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:VIVIAN
Other - Last Name:NICHOLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2602 CONFEDERATE AVE
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2412
Mailing Address - Country:US
Mailing Address - Phone:434-209-4542
Mailing Address - Fax:
Practice Address - Street 1:1108 E MAIN ST STE 701
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-3534
Practice Address - Country:US
Practice Address - Phone:804-608-6577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical