Provider Demographics
NPI:1053490995
Name:VANSETTERS, REBECCA (CSW, ACSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:VANSETTERS
Suffix:
Gender:F
Credentials:CSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11250 HARVARD AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9551
Mailing Address - Country:US
Mailing Address - Phone:616-754-6210
Mailing Address - Fax:616-696-4034
Practice Address - Street 1:261 N MAIN
Practice Address - Street 2:
Practice Address - City:CEDAR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49319-9709
Practice Address - Country:US
Practice Address - Phone:616-696-4034
Practice Address - Fax:616-696-6210
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801035649101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2820641Medicaid
MI8008971700OtherBCBS OF MI
MI2820641Medicaid