Provider Demographics
NPI:1023102035
Name:HUTCHENS, MICHAEL WAYNE (MA, LLMSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:WAYNE
Last Name:HUTCHENS
Suffix:
Gender:M
Credentials:MA, LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6953 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48741-9789
Mailing Address - Country:US
Mailing Address - Phone:989-635-8231
Mailing Address - Fax:
Practice Address - Street 1:217 E SANILAC RD STE 1
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:MI
Practice Address - Zip Code:48471-1383
Practice Address - Country:US
Practice Address - Phone:810-648-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010859211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical