Provider Demographics
NPI:1811147317
Name:SCROGGINS, NYREE A (LMSW)
Entity type:Individual
Prefix:MS
First Name:NYREE
Middle Name:A
Last Name:SCROGGINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:NYREE
Other - Middle Name:A
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-0010
Mailing Address - Country:US
Mailing Address - Phone:517-676-9788
Mailing Address - Fax:
Practice Address - Street 1:2111 UNIVERSITY PARK DR STE 400
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-6907
Practice Address - Country:US
Practice Address - Phone:517-798-4944
Practice Address - Fax:517-708-0066
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801107710104100000X
MI6801090405104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker