Provider Demographics
NPI:1912019662
Name:VANLENTE, JOHN EDWARD (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:EDWARD
Last Name:VANLENTE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 COMMERCE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-2608
Mailing Address - Country:US
Mailing Address - Phone:231-728-2138
Mailing Address - Fax:231-722-4771
Practice Address - Street 1:1823 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-2608
Practice Address - Country:US
Practice Address - Phone:231-728-2138
Practice Address - Fax:231-722-4771
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
S37732Medicare UPIN
Z7889Medicare ID - Type Unspecified