| Doctor Name: | MRS. REBECCA ANNE LONGSTREET |
| NPI Number: | 1225465990 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LLPC, NCC |
| License Number: | 6401013232 |
| Business Practice Address: | 45 N Lapeer St Lake Orion, MI - 483623159 |
| Business Phone Number: | 2486939614 |
| Business Fax Number: | |
| Mailing Address: | 56460 Scotland Blvd, SHELBY TOWNSHIP |
| State: | MI |
| Postal Code: | 483165047 |
| Phone Number: | 2487624011 |
| Fax Number: | |
| NPI Enumeration Date: | 09/26/2013 |
| NPI Last Update Date: | 01/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401013232 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |