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General NPI Number Information
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NPI Number | 1447797212
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Entity Type | Individual
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Provider Name | CRYSTA RANSOM-SOPER LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 6627 ROSE ST
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City | CASS CITY
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State | MI
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Zip | 48726-1262
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Country | US
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Telephone | 989-872-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 138 HARTSHORN ST
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City | BAD AXE
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State | MI
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Zip | 48413-1358
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Country | US
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Telephone | 810-310-0854
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 130375
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801099965
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License Number State | MI
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