Individual provider Active NPI

Rebecca Ann Lawrence, LMFT, RN

  • Mental Health Counselor
  • Crescent City, CA
National Provider Identifier
1104101583
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37503 Issued in CA
Practice address
2721 Alder Rd
Crescent City, CA 95531-8820
Phone
(707) 464-6477
NPI assigned
Oct 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 37503 CA Primary
Registered Nurse 163W00000X 780931 CA

Addresses

Primary practice location

2721 Alder Rd
Crescent City, CA 95531-8820

Mailing address

2721 Alder Rd
Crescent City, CA 95531-8820
Phone (707) 464-6477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
37503CAMDMental Health Counselor
780931CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1104101583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 ALDER RD",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318820",
            "telephone_number": "707-464-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 ALDER RD",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318820",
            "telephone_number": "707-464-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "LMFT, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "37503",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "780931",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.