Active NPI
Rebecca J Welborn, LACA, BSADC,CAPRC II
- Addiction (Substance Use Disorder) Counselor
- Greenfield, IN
National Provider Identifier
1104600592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 99128120A
- Practice address
- 704 N State St Ste a
Greenfield, IN 46140-3616 - Phone
- (317) 406-8191
- NPI assigned
- Aug 24, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | IN | ||
| Peer Specialist | 175T00000X | CAPRC2-5198 | IN | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 99128120A | IN | Primary |
Addresses
Primary practice location
704 N State St Ste a
Greenfield, IN 46140-3616
Mailing address
304 S Jefferson St
Knightstown, IN 46148-1326
Phone (317) 318-4802
Other names 1
- Becky Welborn
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99128120A | IN | MD | Addiction (Substance Use Disorder) Counselor |
| CAPRC2-5198 | IN | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rugged Grace, LLC | Current | Accepting new patients |
Locations
704 N State St
Ste A
Greenfield, IN 46140
Phone (317) 316-9925
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Greenfield, IN
- NPI 1528770831
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731801600000",
"number": "1104600592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 S JEFFERSON ST",
"city": "KNIGHTSTOWN",
"state": "IN",
"postal_code": "461481326",
"telephone_number": "317-318-4802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "704 N STATE ST STE A",
"city": "GREENFIELD",
"state": "IN",
"postal_code": "461403616",
"telephone_number": "317-406-8191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELBORN",
"first_name": "REBECCA",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "LACA, BSADC,CAPRC II",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-24",
"last_updated": "2024-11-17",
"certification_date": "2024-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "IN",
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "IN",
"license": "CAPRC2-5198",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IN",
"license": "99128120A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BECKY",
"last_name": "WELBORN",
"credential": "LACA, BSADC,CAPRC II",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Greenfield, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.