MEDICARE: MR. SHENG AN YANG 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
1	1041C0700X	Clinical Social Worker
2	104100000X	Social Worker	6801082439	MI

General Provider Information

NPI Number	:	1275669608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHENG AN YANG LMSW

Provider Business Mailing Address
First Line	:	300 LAFAYETTE AVE SE STE 4000
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-4692
Country	:	US
Telephone Number	:	616-685-6922
Fax Number	:	616-685-5101

Provider Business Practice Location Address
First Line	:	300 LAFAYETTE AVE SE STE 4000
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-4692
Country	:	US
Telephone Number	:	616-685-6922
Fax Number	:	616-685-5101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	08/06/2020

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Directions to “ MR. SHENG AN YANG LMSW” Practice Location

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