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General NPI Number Information
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NPI Number | 1639042807
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Entity Type | Individual
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Provider Name | JAMIE E LIGHTNER
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Gender | Female
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 2017 4TH ST
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City | JACKSON
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State | MI
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Zip | 49203-4572
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Country | US
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Telephone | 517-581-4886
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Fax |
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Provider Business Mailing Address
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Address Line | 11224 CAMM RD
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City | SPRINGPORT
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State | MI
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Zip | 49284-9429
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Country | US
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Telephone | 517-242-0224
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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 | 6801120957
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License Number State | MI
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