Provider Demographics
NPI:1013066067
Name:AREND-RITTER, TELKA ROSE (MSW)
Entity Type:Individual
Prefix:
First Name:TELKA
Middle Name:ROSE
Last Name:AREND-RITTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 MICHIGAN AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-4070
Mailing Address - Country:US
Mailing Address - Phone:517-364-6253
Mailing Address - Fax:517-364-6208
Practice Address - Street 1:1210 W SAGINAW ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48915-1927
Practice Address - Country:US
Practice Address - Phone:517-364-7700
Practice Address - Fax:517-364-7701
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801020700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8008940130OtherBCBS INDIVIDUAL PIN
MI8008940130OtherBCBS INDIVIDUAL PIN
MIM77610003Medicare PIN