Provider Demographics
NPI:1578998746
Name:ODOM, REBECCA MICHELLE (LCSW, RYT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MICHELLE
Last Name:ODOM
Suffix:
Gender:F
Credentials:LCSW, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 E CHESTNUT ST STE 6
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2480
Mailing Address - Country:US
Mailing Address - Phone:501-584-3057
Mailing Address - Fax:
Practice Address - Street 1:223 E CHESTNUT ST STE 6
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2480
Practice Address - Country:US
Practice Address - Phone:501-584-3057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0099871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical