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General NPI Number Information
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NPI Number | 1639347206
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Entity Type | Individual
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Provider Name | NICHOLAS M PUSCAS LMSW
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Gender | Male
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 6051 FRANKFORT HWY
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City | BENZONIA
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State | MI
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Zip | 49616-9558
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Country | US
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Telephone | 877-398-2013
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Fax | 231-882-2300
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Provider Business Mailing Address
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Address Line | 2025 CARLSON RD
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City | FRANKFORT
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State | MI
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Zip | 49635-9787
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Country | US
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Telephone | 231-352-8136
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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 | 6801046342
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License Number State | MI
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