Healthcare Provider Details

I. General information

NPI: 1730217308
Provider Name (Legal Business Name): PATRICK M LOUGHLIN MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 M 60 E
CASSOPOLIS MI
49031-9339
US

IV. Provider business mailing address

32652 KNO
DOWAGIAC MI
49047-9805
US

V. Phone/Fax

Practice location:
  • Phone: 269-445-2451
  • Fax:
Mailing address:
  • Phone: 269-783-2476
  • Fax: 269-782-0248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: