Provider Demographics
NPI:1679187371
Name:COMPTON, REBECCA SUE (LCSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUE
Last Name:COMPTON
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2578 BROADWAY STE 607
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5642
Mailing Address - Country:US
Mailing Address - Phone:304-308-3735
Mailing Address - Fax:
Practice Address - Street 1:114 COURT ST NE STE 203
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2908
Practice Address - Country:US
Practice Address - Phone:276-200-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000674101YA0400X
VA09040170171041C0700X, 1041C0700X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30016197990005Medicaid