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NPI Code Detail

MEDICARE: M. CHRISTINE CHURCH MSW,LMSW

MEDICARE: M. CHRISTINE CHURCH MSW,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 Worker6801079626MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MC079626MSWOTHERMIBLUE CROSS BLUE SHIELD
20996426OTHERMIHEALTH PLUS INSURANCE
3CHURC-0098OTHERMICOMPCARE INSURANCE

General Provider Information

NPI Number : 1669501292
Entity Type Code : Individual
Provider Name (Legal Business Name) : M. CHRISTINE CHURCH MSW,LMSW
Provider Business Mailing Address
First Line : 68 DAVIS DRIVE
Second Line :
City : SAGINAW
State : MI
Zip : 48602-1900
Country : US
Telephone Number : 989-792-5724
Fax Number : 989-792-5724
Provider Business Practice Location Address
First Line : 1217 S EUCLID AVE
Second Line :
City : BAY CITY
State : MI
Zip : 48706-3311
Country : US
Telephone Number : 989-667-9661
Fax Number : 989-667-9680
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2007
Last Update Date : 07/08/2007

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