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General NPI Number Information
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NPI Number | 1598637001
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Entity Type | Individual
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Provider Name | LACEY NICOLE LINNE
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Gender | Female
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 1605 FORT ST
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City | LINCOLN PARK
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State | MI
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Zip | 48146-1915
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Country | US
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Telephone | 313-389-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 5640 WILLIS RD
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City | YPSILANTI
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State | MI
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Zip | 48197-9548
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Country | US
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Telephone | 734-879-3080
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | --
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License Number State | MI
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