Provider Demographics
NPI:1205807872
Name:SPONSLER, REBECCA R (MS CEAP LMHC)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:R
Last Name:SPONSLER
Suffix:
Gender:F
Credentials:MS CEAP LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 EAST 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022
Mailing Address - Country:US
Mailing Address - Phone:712-243-2606
Mailing Address - Fax:712-243-2688
Practice Address - Street 1:1408 EAST 10TH ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022
Practice Address - Country:US
Practice Address - Phone:712-243-2606
Practice Address - Fax:712-243-2688
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00449101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA00449OtherLICENSED MENTAL HEALTH CO
018549OtherEMPLOYEE ASSISTANCE CERTI