Provider Demographics
NPI:1689743189
Name:LENTNER, TIMOTHY H (MSW)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:H
Last Name:LENTNER
Suffix:
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 1:1 SEAGATE STE 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:734-240-1760
Mailing Address - Fax:734-240-1780
Practice Address - Street 1:730 N MACOMB ST STE 200
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-2904
Practice Address - Country:US
Practice Address - Phone:734-240-1760
Practice Address - Fax:734-240-1780
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801000981104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8008949430OtherBCBS