Healthcare Provider Details

I. General information

NPI: 1033674700
Provider Name (Legal Business Name): ISAAC ADAM ROYER LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2019
Last Update Date: 02/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 S SHORE DR STE 214
BATTLE CREEK MI
49014-5446
US

IV. Provider business mailing address

23 WOOLNOUGH AVE
BATTLE CREEK MI
49017-3725
US

V. Phone/Fax

Practice location:
  • Phone: 269-964-0153
  • Fax: 855-811-5812
Mailing address:
  • Phone: 989-289-7833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801092136
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: