Provider Demographics
NPI:1376803825
Name:REHM, MICHAEL R (LPC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:R
Last Name:REHM
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1300 E MISSOURI AVE
Mailing Address - Street 2:SUITE -100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2362
Mailing Address - Country:US
Mailing Address - Phone:800-273-3429
Mailing Address - Fax:602-626-5224
Practice Address - Street 1:1300 E MISSOURI AVE
Practice Address - Street 2:SUITE -100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2362
Practice Address - Country:US
Practice Address - Phone:800-273-3429
Practice Address - Fax:602-626-5224
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-14136101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional