Healthcare Provider Details

I. General information

NPI: 1639438583
Provider Name (Legal Business Name): REBECCA LYN STIEG LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2012
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 68TH ST SE
GRAND RAPIDS MI
49548-6927
US

IV. Provider business mailing address

700 3 MILE RD NW STE 1
GRAND RAPIDS MI
49544-8220
US

V. Phone/Fax

Practice location:
  • Phone: 162-587-4676
  • Fax:
Mailing address:
  • Phone: 616-226-3952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401009471
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: