Healthcare Provider Details

I. General information

NPI: 1568084143
Provider Name (Legal Business Name): JAMES L HORRIGAN II LMSW AND RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4328 PAGE AVE
MICHIGAN CENTER MI
49254-1077
US

IV. Provider business mailing address

613 WEBB ST
JACKSON MI
49202-3278
US

V. Phone/Fax

Practice location:
  • Phone: 734-769-7100
  • Fax:
Mailing address:
  • Phone: 517-990-0868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801107224
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704275802
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: