Provider Demographics
NPI:1508237884
Name:NITZ, HOWARD III (MSW)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:
Last Name:NITZ
Suffix:III
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11030 PHYLLIS DR
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-1545
Mailing Address - Country:US
Mailing Address - Phone:810-394-7148
Mailing Address - Fax:
Practice Address - Street 1:585 JEWETT RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-8729
Practice Address - Country:US
Practice Address - Phone:517-676-5405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801098109104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker