Healthcare Provider Details

I. General information

NPI: 1588403067
Provider Name (Legal Business Name): WILLIAM TYROUS FRENCH LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2024
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4955 S M-88 HIGHWY
BELLAIRE MI
49615
US

IV. Provider business mailing address

11305 ROBERTS ROAD
CHARLEVOIX MI
49720-8958
US

V. Phone/Fax

Practice location:
  • Phone: 231-533-8649
  • Fax: 231-533-6778
Mailing address:
  • Phone: 765-716-7023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801097040
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: