Provider Demographics
NPI:1770593022
Name:NAHRGANG, LAWRENCE NESTER JR (LMSW ACSW)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:NESTER
Last Name:NAHRGANG
Suffix:JR
Gender:M
Credentials:LMSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:945 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3242
Mailing Address - Country:US
Mailing Address - Phone:173-478-0529
Mailing Address - Fax:
Practice Address - Street 1:9315 TELEGRAPH
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239
Practice Address - Country:US
Practice Address - Phone:313-450-4500
Practice Address - Fax:313-450-4514
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010657781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ON34160004Medicare ID - Type Unspecified