MEDICARE: VALERIE MARIE MCNAMARA LLMSW

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	104100000X	Social Worker	6801106979	MI

General Provider Information

NPI Number	:	1689284788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE MARIE MCNAMARA LLMSW

Provider Business Mailing Address
First Line	:	487 S DRAKE RD STE B
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-3236
Country	:	US
Telephone Number	:	269-779-7577
Fax Number	:	269-775-1121

Provider Business Practice Location Address
First Line	:	487 S DRAKE RD STE B
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-3236
Country	:	US
Telephone Number	:	269-779-7577
Fax Number	:	269-775-1121

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

Provider Enumeration Date	:	08/04/2020
Last Update Date	:	08/04/2020

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