Provider Demographics
NPI:1578042560
Name:SPRAU, NATASHA HELENA (LMSW)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:HELENA
Last Name:SPRAU
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 1:1100 TORREY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-3327
Mailing Address - Country:US
Mailing Address - Phone:810-494-7180
Mailing Address - Fax:248-692-4936
Practice Address - Street 1:1701 LAKE LANSING RD STE 120
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3798
Practice Address - Country:US
Practice Address - Phone:810-494-7180
Practice Address - Fax:810-215-1334
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011029141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical