Provider Demographics
NPI:1518077213
Name:NEMINSKI, SUSAN (BSW,CAC I)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:NEMINSKI
Suffix:
Gender:F
Credentials:BSW,CAC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 MARATHON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIAVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48421-8993
Mailing Address - Country:US
Mailing Address - Phone:810-356-4802
Mailing Address - Fax:
Practice Address - Street 1:1800 IMLAY CITY RD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3208
Practice Address - Country:US
Practice Address - Phone:810-245-4802
Practice Address - Fax:810-245-5676
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-01297101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)