Provider Demographics
NPI:1275614158
Name:FRANZEL, MANDE LYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:MANDE
Middle Name:LYNN
Last Name:FRANZEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 SHABBONA RD
Mailing Address - Street 2:
Mailing Address - City:SNOVER
Mailing Address - State:MI
Mailing Address - Zip Code:48472-9752
Mailing Address - Country:US
Mailing Address - Phone:810-672-9286
Mailing Address - Fax:
Practice Address - Street 1:190 N DELAWARE ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:MI
Practice Address - Zip Code:48471-1009
Practice Address - Country:US
Practice Address - Phone:180-648-0330
Practice Address - Fax:810-648-5107
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010815311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIG76359022Medicare ID - Type Unspecified