Provider Demographics
NPI:1821771684
Name:LINGLE, BRIAN ANDREW (MSW)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:ANDREW
Last Name:LINGLE
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 1:630 DALTON RD
Mailing Address - Street 2:
Mailing Address - City:SKANDIA
Mailing Address - State:MI
Mailing Address - Zip Code:49885-9403
Mailing Address - Country:US
Mailing Address - Phone:906-361-3559
Mailing Address - Fax:
Practice Address - Street 1:630 DALTON RD
Practice Address - Street 2:
Practice Address - City:SKANDIA
Practice Address - State:MI
Practice Address - Zip Code:49885-9403
Practice Address - Country:US
Practice Address - Phone:906-361-3559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health