MEDICARE: GEORGIA MARIE REW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1518809078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGIA MARIE REW

Provider Business Mailing Address
First Line	:	336 HERMOSA AVE APT B
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-3837
Country	:	US
Telephone Number	:	415-216-3958
Fax Number	:

Provider Business Practice Location Address
First Line	:	336 HERMOSA AVE APT B
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-3837
Country	:	US
Telephone Number	:	415-216-3958
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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