Provider Demographics
NPI:1356787725
Name:MAKOWSKI, REBECCA R (MA, LPC-S, NCC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:R
Last Name:MAKOWSKI
Suffix:
Gender:F
Credentials:MA, LPC-S, NCC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:R
Other - Last Name:DICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:135 WESTBROOK
Mailing Address - Street 2:
Mailing Address - City:WHITMORE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48189-8208
Mailing Address - Country:US
Mailing Address - Phone:734-904-5031
Mailing Address - Fax:734-402-8928
Practice Address - Street 1:5840 N CANTON CENTER RD STE 224
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2684
Practice Address - Country:US
Practice Address - Phone:734-904-5031
Practice Address - Fax:734-402-8928
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012196101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional