Healthcare Provider Details

I. General information

NPI: 1366634784
Provider Name (Legal Business Name): MATTHEW REMES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 E GRAND RIVER AVE STE 100
EAST LANSING MI
48823-4958
US

IV. Provider business mailing address

1750 E GRAND RIVER AVE STE 100
EAST LANSING MI
48823-4958
US

V. Phone/Fax

Practice location:
  • Phone: 517-295-3726
  • Fax: 844-927-4501
Mailing address:
  • Phone: 517-295-3726
  • Fax: 844-927-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801089407
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801089407
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: