Provider Demographics
NPI:1255498853
Name:POYER, LORNA ANN (LMSW)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:ANN
Last Name:POYER
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 1:7090 W LAWRENCE
Mailing Address - Street 2:
Mailing Address - City:VERMONTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48096-8548
Mailing Address - Country:US
Mailing Address - Phone:517-541-1996
Mailing Address - Fax:
Practice Address - Street 1:64 VANSICKLE DR
Practice Address - Street 2:STE B
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-9526
Practice Address - Country:US
Practice Address - Phone:517-543-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010857251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
832274000OtherMAGELLAN
MIMCLAREN 1017107Medicaid