Provider Demographics
NPI:1750803870
Name:POPP, JANET (LMSW)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:POPP
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 1:5445 ALI DR DEPT 320
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5193
Mailing Address - Country:US
Mailing Address - Phone:810-428-1181
Mailing Address - Fax:
Practice Address - Street 1:5445 ALI DR DEPT 320
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-5193
Practice Address - Country:US
Practice Address - Phone:810-603-8800
Practice Address - Fax:810-579-7222
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010903031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6802071808OtherLICENSE