Provider Demographics
NPI:1659245348
Name:REAH, MIKAYLA (LLC)
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:
Last Name:REAH
Suffix:
Gender:F
Credentials:LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6032 BEACON HILL ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48506-1630
Mailing Address - Country:US
Mailing Address - Phone:248-961-9271
Mailing Address - Fax:
Practice Address - Street 1:2413 S LINDEN RD STE C
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-5455
Practice Address - Country:US
Practice Address - Phone:810-771-3457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024493101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional