Provider Demographics
NPI:1548295256
Name:REHM, MICHAEL ALAN (LISW-S)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALAN
Last Name:REHM
Suffix:
Gender:M
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 N EWING ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3383
Mailing Address - Country:US
Mailing Address - Phone:740-689-6700
Mailing Address - Fax:740-689-6702
Practice Address - Street 1:131 N EWING ST
Practice Address - Street 2:SUITE B
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3383
Practice Address - Country:US
Practice Address - Phone:740-689-6700
Practice Address - Fax:740-689-6702
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00075161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW16892Medicare PIN