Provider Demographics
NPI:1194709428
Name:REHBERG, JEANNINE M (LMSW)
Entity type:Individual
Prefix:MS
First Name:JEANNINE
Middle Name:M
Last Name:REHBERG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:JEANNINE
Other - Middle Name:M
Other - Last Name:KREGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:180 W. MICHIGAN AVE.
Mailing Address - Street 2:SUITE 802
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1300
Mailing Address - Country:US
Mailing Address - Phone:517-750-8730
Mailing Address - Fax:517-780-9286
Practice Address - Street 1:180 W. MICHIGAN AVE.
Practice Address - Street 2:SUITE 802
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1300
Practice Address - Country:US
Practice Address - Phone:517-750-8730
Practice Address - Fax:517-780-9286
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010869571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical