Provider Demographics
NPI:1043886906
Name:LUGO, STEPHANIE MARYANN (LLMSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARYANN
Last Name:LUGO
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MARYANN
Other - Last Name:SOLORSANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6438 MARTINIE DR APT 7
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49401-9724
Mailing Address - Country:US
Mailing Address - Phone:616-389-5501
Mailing Address - Fax:
Practice Address - Street 1:376 E APPLE AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-3466
Practice Address - Country:US
Practice Address - Phone:231-724-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management