Provider Demographics
NPI:1932400348
Name:REA COUNSELING SERVICES, PC
Entity Type:Organization
Organization Name:REA COUNSELING SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:REA-MICHALAK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP, LMSW
Authorized Official - Phone:586-495-4704
Mailing Address - Street 1:51539 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-4447
Mailing Address - Country:US
Mailing Address - Phone:586-461-2111
Mailing Address - Fax:586-755-6494
Practice Address - Street 1:51539 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48316
Practice Address - Country:US
Practice Address - Phone:586-461-2111
Practice Address - Fax:586-755-6494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014258251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health