1033225362 NPI number — MARGARET M SPENCER PIRROTTA LMSW

Table of content: MARGARET M SPENCER PIRROTTA LMSW (NPI 1033225362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033225362 NPI number — MARGARET M SPENCER PIRROTTA LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPENCER PIRROTTA
Provider First Name:
MARGARET
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033225362
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/05/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2149 JOLLY RD
Provider Second Line Business Mailing Address:
STE 500
Provider Business Mailing Address City Name:
OKEMOS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48864-6028
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-347-4645
Provider Business Mailing Address Fax Number:
517-347-4644

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2289 SOWER BLVD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
OKEMOS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48864-3297
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-347-4645
Provider Business Practice Location Address Fax Number:
517-347-4644
Provider Enumeration Date:
08/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  6801068990 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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