Provider Demographics
NPI:1275669608
Name:YANG, SHENG AN (LMSW)
Entity Type:Individual
Prefix:MR
First Name:SHENG AN
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:MR
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:300 LAFAYETTE AVE SE STE 4000
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4692
Mailing Address - Country:US
Mailing Address - Phone:616-685-6922
Mailing Address - Fax:616-685-5101
Practice Address - Street 1:300 LAFAYETTE AVE SE STE 4000
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4692
Practice Address - Country:US
Practice Address - Phone:616-685-6922
Practice Address - Fax:616-685-5101
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MI6801082439104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D16322Medicare ID - Type Unspecified