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NPI Code Detail

MEDICARE: ERIE JUTILA LMSW

MEDICARE: ERIE JUTILA 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 Worker6801122173MI

General Provider Information

NPI Number : 1982465308
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIE JUTILA LMSW
Provider Business Mailing Address
First Line : 555 TOWNER ST
Second Line :
City : YPSILANTI
State : MI
Zip : 48198-5723
Country : US
Telephone Number : 734-544-3050
Fax Number : 734-544-6732
Provider Business Practice Location Address
First Line : 108 N LAFAYETTE ST STE D
Second Line :
City : GREENVILLE
State : MI
Zip : 48838-1883
Country : US
Telephone Number : 616-200-4030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2024
Last Update Date : 06/02/2026

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Directions to “ ERIE JUTILA LMSW” Practice Location

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