Provider Demographics
NPI:1942093455
Name:WALCZAK, REBECCA PATTERSON (PSYD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:PATTERSON
Last Name:WALCZAK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:BECCA
Other - Middle Name:PATTERSON
Other - Last Name:WALCZAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:3705 W MARKET ST STE B
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1372
Mailing Address - Country:US
Mailing Address - Phone:919-205-8305
Mailing Address - Fax:
Practice Address - Street 1:3705 W MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1372
Practice Address - Country:US
Practice Address - Phone:919-205-8305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6797103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical