Healthcare Provider Details

I. General information

NPI: 1619656428
Provider Name (Legal Business Name): JURASEK WELLNESS CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 SPENCER ST
LANSING MI
48915-1269
US

IV. Provider business mailing address

1515 SPENCER ST
LANSING MI
48915-1269
US

V. Phone/Fax

Practice location:
  • Phone: 517-262-5286
  • Fax:
Mailing address:
  • Phone: 517-262-5286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRIS JURASEK
Title or Position: SOCIAL WORKER
Credential: LMSW
Phone: 517-262-5286