Provider Demographics
NPI:1821607979
Name:PEEK, REBECCA ANN (LLPC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANN
Last Name:PEEK
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:WINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLPC
Mailing Address - Street 1:419 E GLASS RD
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48462-8878
Mailing Address - Country:US
Mailing Address - Phone:810-240-0868
Mailing Address - Fax:
Practice Address - Street 1:550 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2645
Practice Address - Country:US
Practice Address - Phone:810-660-8686
Practice Address - Fax:810-788-1043
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013310101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional