1700453149 NPI number — MRS. MELISSA SUSANNE LININGER LMSW, ADS

Table of content: MRS. MELISSA SUSANNE LININGER LMSW, ADS (NPI 1700453149)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700453149 NPI number — MRS. MELISSA SUSANNE LININGER LMSW, ADS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LININGER
Provider First Name:
MELISSA
Provider Middle Name:
SUSANNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMSW, ADS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LININGER
Provider Other First Name:
MELISSA
Provider Other Middle Name:
SUSANNE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMSW, ADS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700453149
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/04/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PAIN MANAGEMENT CENTER
Provider Second Line Business Mailing Address:
1200 E. MICHIGAN AVENUE
Provider Business Mailing Address City Name:
LANSING
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48912
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-317-5541
Provider Business Mailing Address Fax Number:
517-364-5335

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PAIN MANAGEMENT CENTER
Provider Second Line Business Practice Location Address:
1200 E. MICHIGAN AVENUE
Provider Business Practice Location Address City Name:
LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-317-5541
Provider Business Practice Location Address Fax Number:
517-364-5335
Provider Enumeration Date:
06/04/2021

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: 1041C0700X , with the licence number:  6801109036 , 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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