Provider Demographics
NPI:1669643169
Name:NEUMANN, JOHN F JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:F
Last Name:NEUMANN
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3513 ELIZABETH LAKE RD
Mailing Address - Street 2:#209
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-3075
Mailing Address - Country:US
Mailing Address - Phone:248-738-1100
Mailing Address - Fax:
Practice Address - Street 1:3513 ELIZABETH LAKE RD
Practice Address - Street 2:#209
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3075
Practice Address - Country:US
Practice Address - Phone:248-738-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010214921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0897719OtherBLUE CROSS BLUE SHIELD