Provider Demographics
NPI:1942897541
Name:TOTH, REBECCA LEE (LMSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LEE
Last Name:TOTH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:
Other - Last Name:TOTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:728 FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-2624
Mailing Address - Country:US
Mailing Address - Phone:912-310-0300
Mailing Address - Fax:
Practice Address - Street 1:728 FOREST CIR
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-2624
Practice Address - Country:US
Practice Address - Phone:912-310-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW002892104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAMSW002892OtherMASTER OF SOCIAL WORKER / STATE OF GEORGIA