Provider Demographics
NPI:1881003663
Name:LAPONSIE, JEFFREY (LMSW-C)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:LAPONSIE
Suffix:
Gender:M
Credentials:LMSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6838 MARLOW ST
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-3341
Mailing Address - Country:US
Mailing Address - Phone:269-615-7637
Mailing Address - Fax:
Practice Address - Street 1:614 ROMENCE RD STE 245
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-3613
Practice Address - Country:US
Practice Address - Phone:269-615-7637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010953681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical