Basic Information
Provider Information
NPI: 1548313810
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOWE
FirstName: PATRICIA
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 MICHIGAN ST NE
Address2: MC 845
City: GRAND RAPIDS
State: MI
PostalCode: 495032560
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4100 LAKE DR SE
Address2: SUITE 205
City: GRAND RAPIDS
State: MI
PostalCode: 495468292
CountryCode: US
TelephoneNumber: 6162677414
FaxNumber: 6162677137
Other Information
ProviderEnumerationDate: 01/19/2007
LastUpdateDate: 11/10/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X6801057189MIY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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