Provider Demographics
NPI:1730846908
Name:HAGERLING, REBECCA ANGELIQUE (MS, LPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANGELIQUE
Last Name:HAGERLING
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4635 E HOUGHTON LAKE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49651-9546
Mailing Address - Country:US
Mailing Address - Phone:956-572-4330
Mailing Address - Fax:
Practice Address - Street 1:4635 E HOUGHTON LAKE RD
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:MI
Practice Address - Zip Code:49651-9546
Practice Address - Country:US
Practice Address - Phone:956-572-4330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80326101YM0800X
MI6401225057101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty