MEDICARE: BRETT STANAWAY 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
1	1041C0700X	Clinical Social Worker	6801117394	MI
2	104100000X	Social Worker	6851094683	MI

General Provider Information

NPI Number	:	1750074332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT STANAWAY LMSW

Provider Business Mailing Address
First Line	:	PO BOX 30161
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48909-7661
Country	:	US
Telephone Number	:	517-887-4345
Fax Number	:

Provider Business Practice Location Address
First Line	:	815 N FAIRVIEW AVE RM 100
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48912-3129
Country	:	US
Telephone Number	:	517-887-4349
Fax Number	:

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

Provider Enumeration Date	:	05/31/2023
Last Update Date	:	07/24/2025

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Directions to “ BRETT STANAWAY LMSW” Practice Location

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