Healthcare Provider Details

I. General information

NPI: 1871418400
Provider Name (Legal Business Name): REBEKAH DANIELLE RILEY LLBSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 S TOWNLINE RD
HOUGHTON LAKE MI
48629-9294
US

IV. Provider business mailing address

2715 S TOWNLINE RD
HOUGHTON LAKE MI
48629-9294
US

V. Phone/Fax

Practice location:
  • Phone: 989-366-8550
  • Fax:
Mailing address:
  • Phone: 231-633-8218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6852094585
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: