MEDICARE: MS. REBEKAH ANDERSON MA, LLC, CAADC-D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6451023031	MI
2	101Y00000X	Counselor	6451023031	MI

General Provider Information

NPI Number	:	1598485286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBEKAH ANDERSON MA, LLC, CAADC-D

Provider Business Mailing Address
First Line	:	4111 LILAC LN
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49685-7807
Country	:	US
Telephone Number	:	231-645-7150
Fax Number	:

Provider Business Practice Location Address
First Line	:	4111 LILAC LN
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49685-7807
Country	:	US
Telephone Number	:	231-645-7150
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2022
Last Update Date	:	06/28/2026

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