Provider Demographics
NPI:1588029235
Name:MARCEAU, GENEVIEVE DEZYREE (LMSW)
Entity type:Individual
Prefix:MS
First Name:GENEVIEVE
Middle Name:DEZYREE
Last Name:MARCEAU
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:GENEVIEVE
Other - Middle Name:DEZYREE
Other - Last Name:HANES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:1596 E M 21 STE 247
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-9050
Mailing Address - Country:US
Mailing Address - Phone:989-270-6262
Mailing Address - Fax:989-419-5940
Practice Address - Street 1:1596 E M 21 STE 247
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-9050
Practice Address - Country:US
Practice Address - Phone:989-270-6262
Practice Address - Fax:989-419-5940
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-23
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011156371041C0700X
MI68011028611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical