Provider Demographics
NPI:1386533206
Name:REMBISZ, JOHN JOSEPH
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:REMBISZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 GREEN RD
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-9234
Mailing Address - Country:US
Mailing Address - Phone:517-375-3674
Mailing Address - Fax:
Practice Address - Street 1:41700 GARDENBROOK RD OFC B
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1324
Practice Address - Country:US
Practice Address - Phone:248-460-9367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851120104104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker