Healthcare Provider Details

I. General information

NPI: 1467312967
Provider Name (Legal Business Name): OSCAR CORTEZ III LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5656 S CEDAR ST
LANSING MI
48911-3894
US

IV. Provider business mailing address

4394 OKEMOS RD APT A205
OKEMOS MI
48864-2549
US

V. Phone/Fax

Practice location:
  • Phone: 269-986-6093
  • Fax:
Mailing address:
  • Phone: 517-348-5672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801121251
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: