Provider Demographics
NPI:1932298239
Name:ZMICH-CULLEN, LISA CAROL (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:CAROL
Last Name:ZMICH-CULLEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:198 CHURCH ST.
Mailing Address - City:REMUS
Mailing Address - State:MI
Mailing Address - Zip Code:49340-0331
Mailing Address - Country:US
Mailing Address - Phone:989-967-3629
Mailing Address - Fax:
Practice Address - Street 1:301 S CRAPO ST STE 200
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2941
Practice Address - Country:US
Practice Address - Phone:989-772-5938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010678251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical