Healthcare Provider Details

I. General information

NPI: 1144056961
Provider Name (Legal Business Name): ANNMARIE LOUISE LOUTZENHISER LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNMARIE LOUISE EDE LLMSW

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 W PINE LAKE DR
NEWAYGO MI
49337-9339
US

IV. Provider business mailing address

187 W PINE LAKE DR
NEWAYGO MI
49337-9339
US

V. Phone/Fax

Practice location:
  • Phone: 586-879-8259
  • Fax:
Mailing address:
  • Phone: 586-879-8259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6851116607
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: