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General NPI Number Information
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NPI Number | 1710215199
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Entity Type | Organization
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Legal Business Name | PATRICIA MARCINIAK, LMSW ACSW LLC
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Dates
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Enumeration Date | 11/24/2009
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 6026 HARKSON DR
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City | EAST LANSING
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State | MI
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Zip | 48823-1513
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Country | US
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Telephone | 517-332-2006
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Fax | 517-332-2006
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Provider Business Mailing Address
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Address Line | 6026 HARKSON DR
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City | EAST LANSING
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State | MI
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Zip | 48823-1513
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Country | US
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Telephone | 517-332-2006
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Fax | 517-332-2006
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Authorized Official
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Title or Position | LICENSED MASTER SOCIAL WORKER
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Name | MS. PATRICIA MARCINIAK
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Credential | LMSW, ACSW
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Telephone | 517-332-2006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6801062760
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License Number State | MI
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