Provider Demographics
NPI:1659606374
Name:HOWLEY, LARRY H (LMSW)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:H
Last Name:HOWLEY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-1118
Mailing Address - Country:US
Mailing Address - Phone:269-323-1954
Mailing Address - Fax:269-323-4183
Practice Address - Street 1:5805 OAKLAND DR
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-1118
Practice Address - Country:US
Practice Address - Phone:269-323-1954
Practice Address - Fax:269-323-4180
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010332431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical