Healthcare Provider Details

I. General information

NPI: 1598485286
Provider Name (Legal Business Name): REBEKAH ANDERSON MA, LLC, CAADC-D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 43
GRAWN MI
49637-0043
US

IV. Provider business mailing address

PO BOX 43
GRAWN MI
49637-0043
US

V. Phone/Fax

Practice location:
  • Phone: 231-645-7150
  • Fax: 616-207-7703
Mailing address:
  • Phone: 231-645-7150
  • Fax: 616-207-7703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451023031
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6451023031
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: