1972579407 NPI number — DR. REBECCA RENEE RENDON-LOTT PSY.D, LPC, LCPC,NCC

Table of content: (NPI 1427266253)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972579407 NPI number — DR. REBECCA RENEE RENDON-LOTT PSY.D, LPC, LCPC,NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RENDON-LOTT
Provider First Name:
REBECCA
Provider Middle Name:
RENEE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSY.D, LPC, LCPC,NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972579407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 68368
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCHAUMBURG
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60168-0368
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-417-0350
Provider Business Mailing Address Fax Number:
630-672-1425

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 S CAPITAL OF TEXAS HWY
Provider Second Line Business Practice Location Address:
BLDG C SUITE 130
Provider Business Practice Location Address City Name:
WEST LAKE HILLS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78746-6574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-417-0350
Provider Business Practice Location Address Fax Number:
630-672-1425
Provider Enumeration Date:
02/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  14399 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP2500X , with the licence number: 180-004198 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)