Provider Demographics
NPI:1144958919
Name:ADDUCI, REBECCA ANN (LCSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:ADDUCI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BECCA
Other - Middle Name:
Other - Last Name:ADDUCI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3701 LAKE ONTARIO DR APT 105
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-6748
Mailing Address - Country:US
Mailing Address - Phone:219-334-8719
Mailing Address - Fax:
Practice Address - Street 1:3701 LAKE ONTARIO DR APT 105
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-6748
Practice Address - Country:US
Practice Address - Phone:219-334-8719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007208A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical