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217 N Sycamore St Lansing MI 48933-1033 | |
| (517) 897-9001 | |
| (517) 580-7128 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 217 N Sycamore St, Lansing, Michigan |
| Authorized Official Name and Position | Jacquelyn Liebner (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5178979001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
217 N Sycamore St Lansing MI 48933-1033 Ph: (517) 897-9001 | 217 N Sycamore St Lansing MI 48933-1033 Ph: (517) 897-9001 |
| NPI Number | 1316430549 |
|---|---|
| Provider Enumeration Date | 06/12/2018 |
| Last Update Date | 06/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316430549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801096160 (Michigan) | Primary |
| 251B00000X | Case Management | 6801096160 (Michigan) | Secondary |
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