Provider Demographics
NPI:1790965705
Name:ROZEMA, REBECCA LYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:ROZEMA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:323 W 34TH ST
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:616-232-6675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0079841041C0700X
MI68010893381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical