Provider Demographics
NPI:1356577696
Name:LEMAHIEU, DONALD RAY (MSW, ACSW, DCSW)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:RAY
Last Name:LEMAHIEU
Suffix:
Gender:M
Credentials:MSW, ACSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 E 16TH ST
Mailing Address - Street 2:SUITE 290
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3786
Mailing Address - Country:US
Mailing Address - Phone:616-355-7051
Mailing Address - Fax:616-355-7064
Practice Address - Street 1:675 E 16TH ST
Practice Address - Street 2:SUITE 290
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3786
Practice Address - Country:US
Practice Address - Phone:616-355-7051
Practice Address - Fax:616-355-7064
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI19819311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI80-0G01479-0OtherBLUE CROSS/BLUE SHIELD OF MICHIGAN
MI80-0-89-5937-0OtherBLUE CROSS/BLUE SHIELD OF MICHIGAN PIN