Healthcare Provider Details

I. General information

NPI: 1194709428
Provider Name (Legal Business Name): JEANNINE M. REHBERG LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. JEANNINE M. KREGER

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 W. MICHIGAN AVE. SUITE 802
JACKSON MI
49201-1300
US

IV. Provider business mailing address

180 W. MICHIGAN AVE. SUITE 802
JACKSON MI
49201-1300
US

V. Phone/Fax

Practice location:
  • Phone: 517-750-8730
  • Fax: 517-780-9286
Mailing address:
  • Phone: 517-750-8730
  • Fax: 517-780-9286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801086957
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: