Provider Demographics
NPI:1336339787
Name:DAVIS, REBECCA FAITH (MA, LLPC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:FAITH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14840 6 1/2 MILE RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-9502
Mailing Address - Country:US
Mailing Address - Phone:269-962-6987
Mailing Address - Fax:
Practice Address - Street 1:4625 BECKLEY RD
Practice Address - Street 2:STE. 300
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-7948
Practice Address - Country:US
Practice Address - Phone:269-979-8119
Practice Address - Fax:269-979-8124
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010244101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401010244OtherSTATE LICENSE