=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982320016
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REBECCA S PERRY LMSW MENTAL HEALTH COUNSELING SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2022
-----------------------------------------------------
Last Update Date | 01/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6322 S FRIEGEL RD
-----------------------------------------------------
City | OWOSSO
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48867-9263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-640-1500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6322 S FRIEGEL RD
-----------------------------------------------------
City | OWOSSO
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48867-9263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-640-1500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE MEMBER / AUTHORIZED OFFICIAL
-----------------------------------------------------
Name | REBECCA SUE PERRY
-----------------------------------------------------
Credential | LMSW
-----------------------------------------------------
Telephone | 989-640-1500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------