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General NPI Number Information
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NPI Number | 1912131376
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Entity Type | Individual
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Provider Name | REBECCA MATRANGA MA, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 05/13/2009
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 14500 N SHELDON RD # 160B
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City | PLYMOUTH
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State | MI
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Zip | 48170-2597
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Country | US
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Telephone | 248-346-6076
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Fax |
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Provider Business Mailing Address
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Address Line | 9865 HIGH MEADOW DR
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City | YPSILANTI
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State | MI
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Zip | 48198-3285
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Country | US
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Telephone | 248-346-6076
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401011642
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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