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NPI Code Detail

MEDICARE: MS. CONNIE M VANDER SCHEL MSW, LMSW

MEDICARE: MS. CONNIE M VANDER SCHEL MSW, LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801018094MI

General Provider Information

NPI Number : 1144415027
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CONNIE M VANDER SCHEL MSW, LMSW
Provider Business Mailing Address
First Line : 1870 LEONARD ST NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49505-5650
Country : US
Telephone Number : 616-956-1122
Fax Number : 616-956-8033
Provider Business Practice Location Address
First Line : 1870 LEONARD ST NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49505-5650
Country : US
Telephone Number : 616-956-1122
Fax Number : 616-956-8033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2007
Last Update Date : 06/10/2013

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