Provider Demographics
NPI:1720088719
Name:STEIN, TAMARA ELIZABETH (MSW)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:ELIZABETH
Last Name:STEIN
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 1:2626 GROESBECK AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-4520
Mailing Address - Country:US
Mailing Address - Phone:517-316-6731
Mailing Address - Fax:
Practice Address - Street 1:2626 GROESBECK AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-4520
Practice Address - Country:US
Practice Address - Phone:517-618-1891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-31
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010851061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical