Provider Demographics
NPI:1477921997
Name:DOWNER, CHARMEIN TALISE (MSW)
Entity type:Individual
Prefix:MRS
First Name:CHARMEIN
Middle Name:TALISE
Last Name:DOWNER
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 1:4358 DELL RD APT G
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-8143
Mailing Address - Country:US
Mailing Address - Phone:517-894-6920
Mailing Address - Fax:
Practice Address - Street 1:2025 S. WASHINGTON AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910
Practice Address - Country:US
Practice Address - Phone:517-371-1111
Practice Address - Fax:517-371-1121
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical