Provider Demographics
NPI:1235929100
Name:BASILE, REBECCA (CBT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BASILE
Suffix:
Gender:F
Credentials:CBT
Other - Prefix:
Other - First Name:BECKI
Other - Middle Name:
Other - Last Name:BASILE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CBT
Mailing Address - Street 1:1622 TERMINAL DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-4953
Mailing Address - Country:US
Mailing Address - Phone:360-984-3131
Mailing Address - Fax:
Practice Address - Street 1:1622 TERMINAL DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-4953
Practice Address - Country:US
Practice Address - Phone:360-984-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACB61618455106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician