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General NPI Number Information
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NPI Number | 1912019662
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Entity Type | Individual
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Provider Name | JOHN EDWARD VANLENTE LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/05/2012
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Provider Practice Location Address
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Address Line | 1823 COMMERCE ST
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City | MUSKEGON
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State | MI
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Zip | 49441-2608
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Country | US
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Telephone | 231-728-2138
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Fax | 231-722-4771
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Provider Business Mailing Address
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Address Line | 1823 COMMERCE ST SUITE A
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City | MUSKEGON
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State | MI
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Zip | 49441-2608
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Country | US
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Telephone | 231-728-2138
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Fax | 231-722-4771
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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