Provider Demographics
NPI:1245644962
Name:NOWAK, ANNE CATHERINE (LMSW, CBIS)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:CATHERINE
Last Name:NOWAK
Suffix:
Gender:F
Credentials:LMSW, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3026 N BASS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PIERSON
Mailing Address - State:MI
Mailing Address - Zip Code:49339-9411
Mailing Address - Country:US
Mailing Address - Phone:616-901-4348
Mailing Address - Fax:
Practice Address - Street 1:110 SANBORN AVE STE A
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-8740
Practice Address - Country:US
Practice Address - Phone:616-202-1506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-20
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010969101041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical