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General NPI Number Information
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NPI Number | 1750552675
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Entity Type | Individual
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Provider Name | JAMES E GORMAN LMSW
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Gender | Male
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 151 NORTH AVE
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City | BATTLE CREEK
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State | MI
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Zip | 49017-3418
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Country | US
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Telephone | 269-968-2811
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Fax | 269-968-2651
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Provider Business Mailing Address
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Address Line | PO BOX 592
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City | OKEMOS
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State | MI
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Zip | 48805-0592
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Country | US
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Telephone | 517-416-6341
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Fax | 269-968-2651
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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 | 6801067753
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License Number State | MI
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