Healthcare Provider Details
I. General information
NPI: 1134715154
Provider Name (Legal Business Name): LANCE CURTIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/14/2020
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
315 W LAKE LANSING RD STE 500
EAST LANSING MI
48823-1578
US
IV. Provider business mailing address
3125 STATEN AVE APT 12
LANSING MI
48910-6704
US
V. Phone/Fax
- Phone: 517-657-3533
- Fax:
- Phone: 517-887-0226
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 6851122445 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: