Healthcare Provider Details

I. General information

NPI: 1659201622
Provider Name (Legal Business Name): LOGAN LAINE ROWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1381 CLEAVER RD
CARO MI
48723-9135
US

IV. Provider business mailing address

6276 GERMANIA RD
CASS CITY MI
48726-9612
US

V. Phone/Fax

Practice location:
  • Phone: 989-673-5200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6851118079
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: