Healthcare Provider Details

I. General information

NPI: 1427943679
Provider Name (Legal Business Name): PHOEBE CAROLINE POHL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 W LAKE LANSING RD STE 200
EAST LANSING MI
48823-6372
US

IV. Provider business mailing address

830 W LAKE LANSING RD STE 200
EAST LANSING MI
48823-6372
US

V. Phone/Fax

Practice location:
  • Phone: 517-624-1416
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851113970
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: