Healthcare Provider Details

I. General information

NPI: 1326412651
Provider Name (Legal Business Name): SYLVIA CRUTHERS LMSW, ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2015
Last Update Date: 11/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3493 WOODS EDGE STE 103
OKEMOS MI
48864-6030
US

IV. Provider business mailing address

3493 WOODS EDGE STE 103
OKEMOS MI
48864-6030
US

V. Phone/Fax

Practice location:
  • Phone: 517-886-3707
  • Fax: 517-349-1973
Mailing address:
  • Phone: 517-886-3707
  • Fax: 517-349-1973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801021538
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: