Provider Demographics
NPI:1629521034
Name:LOMASNEY, CANDACE (BSW)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:LOMASNEY
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12141 DANFORTH DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-2134
Mailing Address - Country:US
Mailing Address - Phone:586-651-4514
Mailing Address - Fax:
Practice Address - Street 1:12141 DANFORTH DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-2134
Practice Address - Country:US
Practice Address - Phone:586-651-4514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker