Basic Information
| Provider Information | |||||||||
| NPI: | 1013066067 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AREND-RITTER | ||||||||
| FirstName: | TELKA | ||||||||
| MiddleName: | ROSE | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1151 MICHIGAN AVE | ||||||||
| Address2: | STE 110 | ||||||||
| City: | EAST LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488234070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173646253 | ||||||||
| FaxNumber: | 5173646208 | ||||||||
| Practice Location | |||||||||
| Address1: | 1210 W SAGINAW ST | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489151927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173647700 | ||||||||
| FaxNumber: | 5173647701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2007 | ||||||||
| LastUpdateDate: | 11/14/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6801020700 | MI | Y | Behavioral Health & Social Service Providers | Social Worker |
ID Information
| ID | Type | State | Issuer | Description | 8008940130 | 01 | MI | BCBS INDIVIDUAL PIN | OTHER |