Provider Demographics
NPI:1376522151
Name:SLUYTER, ANNE (MA, LMSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:SLUYTER
Suffix:
Gender:F
Credentials:MA, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 W MAIN ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-6114
Mailing Address - Country:US
Mailing Address - Phone:269-372-2860
Mailing Address - Fax:269-353-8649
Practice Address - Street 1:9605 W KL AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-7929
Practice Address - Country:US
Practice Address - Phone:269-375-7023
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010085091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI100784OtherBLUE CARE NETWORK
MI0890752OtherBLUE CROSS/BLUE SHIELD