Provider Demographics
NPI:1114273109
Name:LAURIE EPSTEIN KACH LMSW ACSW LLC
Entity Type:Organization
Organization Name:LAURIE EPSTEIN KACH LMSW ACSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:EPSTEIN
Authorized Official - Last Name:KACH
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, ACSW
Authorized Official - Phone:248-508-1411
Mailing Address - Street 1:29260 FRANKLIN RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1161
Mailing Address - Country:US
Mailing Address - Phone:248-508-1411
Mailing Address - Fax:
Practice Address - Street 1:29260 FRANKLIN RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1161
Practice Address - Country:US
Practice Address - Phone:248-508-1411
Practice Address - Fax:248-352-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2012-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010673091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty