Healthcare Provider Details

I. General information

NPI: 1700117363
Provider Name (Legal Business Name): COURTNEY REBECCA ROBERTS M.A., L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2010
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 W BROADWAY ST STE 230
MT PLEASANT MI
48858-2575
US

IV. Provider business mailing address

113 W BROADWAY ST STE 230
MOUNT PLEASANT MI
48858-2575
US

V. Phone/Fax

Practice location:
  • Phone: 989-619-1195
  • Fax:
Mailing address:
  • Phone: 989-619-1195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401011748
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: