Healthcare Provider Details

I. General information

NPI: 1285948471
Provider Name (Legal Business Name): ADRIENNE MARIE WELLS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 KERRY ST STE 200
LANSING MI
48912-3671
US

IV. Provider business mailing address

300 BAILEY ST STE 2
EAST LANSING MI
48823-4688
US

V. Phone/Fax

Practice location:
  • Phone: 517-273-2706
  • Fax:
Mailing address:
  • Phone: 517-273-2706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801092138
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801092138
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: