Provider Demographics
NPI:1578671178
Name:REAUME, LUANNE MARIE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LUANNE
Middle Name:MARIE
Last Name:REAUME
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 1:4925 PACKARD ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1521
Mailing Address - Country:US
Mailing Address - Phone:734-971-9781
Mailing Address - Fax:734-971-2730
Practice Address - Street 1:8254 DRIGGS RD
Practice Address - Street 2:
Practice Address - City:BLISSFIELD
Practice Address - State:MI
Practice Address - Zip Code:49228-9612
Practice Address - Country:US
Practice Address - Phone:517-486-2034
Practice Address - Fax:517-486-5208
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401001316101YP2500X
MI68010344241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP24010002Medicare ID - Type Unspecified