MEDICARE: ALYSSA NURENBERG LLMSW

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
1	104100000X	Social Worker	6851116936	MI

General Provider Information

NPI Number	:	1306701008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA NURENBERG LLMSW

Provider Business Mailing Address
First Line	:	2005 E BLUEWATER HWY
Second Line	:
City	:	IONIA
State	:	MI
Zip	:	48846-8725
Country	:	US
Telephone Number	:	616-597-6080
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 E BLUEWATER HWY
Second Line	:
City	:	IONIA
State	:	MI
Zip	:	48846-8725
Country	:	US
Telephone Number	:	616-597-6080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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