Provider Demographics
NPI:1861228421
Name:LEBOVITZ, REBECCA (MED, LPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LEBOVITZ
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 W ROSCOE ST APT 1D
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-2962
Mailing Address - Country:US
Mailing Address - Phone:224-688-5520
Mailing Address - Fax:
Practice Address - Street 1:1011 W WELLINGTON AVE STE 210
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-7187
Practice Address - Country:US
Practice Address - Phone:312-757-5739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178020578101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor