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NPI Code Detail

MEDICARE: STACEY M HERKNER LMSW

MEDICARE: STACEY M HERKNER 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
1104100000XSocial Worker6801068003MI

General Provider Information

NPI Number : 1548212327
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY M HERKNER LMSW
Provider Business Mailing Address
First Line : 3785 BAY RD
Second Line :
City : SAGINAW
State : MI
Zip : 48603-2433
Country : US
Telephone Number : 989-791-2455
Fax Number : 989-791-1392
Provider Business Practice Location Address
First Line : 1714 EASTMAN AVE
Second Line :
City : MIDLAND
State : MI
Zip : 48640-4216
Country : US
Telephone Number : 989-631-5390
Fax Number : 989-631-0488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 04/17/2022

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Directions to “ STACEY M HERKNER LMSW” Practice Location

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