Healthcare Provider Details

I. General information

NPI: 1568557999
Provider Name (Legal Business Name): JOANNE ELLEN LUCIER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4970 NORTHWIND STE. 220
EAST LANSING MI
48823-5032
US

IV. Provider business mailing address

227 KATHERYN STREET
MASO MI
48854
US

V. Phone/Fax

Practice location:
  • Phone: 517-333-7115
  • Fax: 989-345-5803
Mailing address:
  • Phone: 517-676-2891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801082271
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: