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General NPI Number Information
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NPI Number | 1497080550
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Entity Type | Individual
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Provider Name | REBECCA SCARBROUGH LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 12/20/2018
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Provider Practice Location Address
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Address Line | 2144 E PARIS AVE SE STE 200
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-6126
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Country | US
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Telephone | 616-685-2100
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Fax | 616-685-2111
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Provider Business Mailing Address
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Address Line | 1900 44TH ST SE
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City | KENTWOOD
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State | MI
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Zip | 49508-5008
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW 00009656
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801086934
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License Number State | MI
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