Vicki Lynn Pula-Jurek, L.M.S.W.
Individual provider Active NPI Clinical Social Worker · Twining, MI
NPI 1861547481 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1861547481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801060141 (MI)
- Practice address
- 1171 North Hale Road
Twining, MI 48766-9793 - Phone
- (989) 867-4262
- Fax
- (989) 867-4334
- NPI assigned
- Jan 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801060141 | MI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801060141 | MI | Yes |
Addresses
Primary practice location
1171 North Hale Road
Twining, MI 48766-9793
Mailing address
1171 North M-65
Twining, MI 48766
Phone (989) 867-4262
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0894289 | Other | MI | BLUE CROSS BLUE SHIE PIN |
| 096298 | Other | MI | VALUE OPTIONS |
Other providers in Twining, MI
All providers in Twining, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.