Provider Demographics
NPI:1346979192
Name:REBECCA ROZEMA, LMSW
Entity Type:Organization
Organization Name:REBECCA ROZEMA, LMSW
Other - Org Name:RIPPLES OF CHANGE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROZEMA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LMSW
Authorized Official - Phone:616-885-0381
Mailing Address - Street 1:323 W 34TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4608
Mailing Address - Country:US
Mailing Address - Phone:616-885-0381
Mailing Address - Fax:
Practice Address - Street 1:323 W 34TH ST STE 100
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4608
Practice Address - Country:US
Practice Address - Phone:616-885-0381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)