Provider Demographics
NPI:1720243090
Name:HAARER, MARCIA ELIZABETH (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:ELIZABETH
Last Name:HAARER
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 1:117 N 1ST ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-1354
Mailing Address - Country:US
Mailing Address - Phone:734-668-6854
Mailing Address - Fax:
Practice Address - Street 1:117 N 1ST ST
Practice Address - Street 2:SUITE 106
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-1354
Practice Address - Country:US
Practice Address - Phone:734-668-6854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010209461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI80(0897328)0OtherBLUE CROSS BLUE SHIELD