Provider Demographics
NPI:1447542667
Name:BIANCHI, REBECCA ANNE (LMHC)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:ANNE
Last Name:BIANCHI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANNE
Other - Last Name:JESZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35 MAIN ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:STURBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01566-1245
Mailing Address - Country:US
Mailing Address - Phone:774-230-4006
Mailing Address - Fax:
Practice Address - Street 1:35 MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:STURBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01566-1245
Practice Address - Country:US
Practice Address - Phone:774-230-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health