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Organization
TMCM4 LLC
Active
Organization
TMCM4 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY BETH HOUPT (CREDENTIALING)
(517) 676-9788
Entity
Organization
Contact information
Practice address
271 WOODLAND PASS STE 216, EAST LANSING, MI 48823-2060
(517) 347-6944
(517) 347-6912
Mailing address
PO BOX 10, MASON, MI 48854-0010
(517) 676-9788
(866) 776-7556
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
6801059540
MI
Other
Enumeration date
09/02/2016
Last updated
05/14/2021
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