Provider Demographics
NPI:1962036574
Name:LADYBUG SOCIAL WORK SERVICES PLLC
Entity Type:Organization
Organization Name:LADYBUG SOCIAL WORK SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:LACY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:231-733-7997
Mailing Address - Street 1:220 BAY ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2473
Mailing Address - Country:US
Mailing Address - Phone:231-373-7997
Mailing Address - Fax:231-348-6180
Practice Address - Street 1:220 BAY ST
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2473
Practice Address - Country:US
Practice Address - Phone:231-373-7997
Practice Address - Fax:231-348-6180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty