NPIMap

Organization Active NPI

Eagle Wings, LLC

  • Social Worker
  • Lansing, MI
National Provider Identifier
1891947248
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6301005177 Issued in MI
Legal business name
EAGLE WINGS, LLC
Practice address
1020 Long Blvd
#5
Lansing, MI 48911-6896
Phone
(517) 420-6123
NPI assigned
Oct 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David J Brock, ACSWNPI 1912159351
Title
Owner
Phone
(517) 420-6123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 6301005177 MI Primary

Addresses

Primary practice location

1020 Long Blvd
#5
Lansing, MI 48911-6896

Mailing address

1538 Stoney PT
Lansing, MI 48917-1450
Phone (517) 323-8395

National Provider Directory

National Provider Directory

Locations

1020 Long Blvd
Ste 5
Lansing, MI 48911
Phone (517) 420-6123

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1891947248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1538 STONEY PT",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489171450",
            "telephone_number": "517-323-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 LONG BLVD",
            "address_2": "#5",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489116896",
            "telephone_number": "517-420-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE WINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-420-6123",
        "authorized_official_credential": "ACSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6301005177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.