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NPI Code Detail

MEDICARE: ELLI STUK LMSW

MEDICARE: ELLI STUK LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801121891MI

General Provider Information

NPI Number : 1073292215
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLI STUK LMSW
Provider Business Mailing Address
First Line : 2303 KALAMAZOO AVE SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-3780
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2303 KALAMAZOO AVE SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-3780
Country : US
Telephone Number : 616-965-8390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2023
Last Update Date : 03/17/2026

Similar Medicare Providers

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Practice Location Address:
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Practice Fax:
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1891887584 — PAULA R VANDERMEULEN LMSW
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Practice Fax:
1356420657 — PAMELA KAY HUFFMAN LLMSW
Practice Location Address:
2303 KALAMAZOO AVE SE
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Practice Fax:
1780739888 — CHERYL LYNN BAKER LMSW
Practice Location Address:
2303 KALAMAZOO AVE SE
GRAND RAPIDS, MI
49507-3780
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Practice Fax:
1457480436 — ANNETTE K KOLB LMSW
Practice Location Address:
2303 KALAMAZOO AVE SE
GRAND RAPIDS, MI
49507-3780
Practice Phone: 616-965-8390
Practice Fax: 616-233-0689

Directions to “ ELLI STUK LMSW” Practice Location

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