Basic Information
Provider Information
NPI: 1689767279
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PIPER
FirstName: ROBIN
MiddleName: RENWICK
NamePrefix:  
NameSuffix:  
Credential: LMSW ACSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 10
Address2:  
City: MASON
State: MI
PostalCode: 488540010
CountryCode: US
TelephoneNumber: 5176769788
FaxNumber: 5176763438
Practice Location
Address1: 790 W LAKE LANSING RD STE 300
Address2:  
City: EAST LANSING
State: MI
PostalCode: 488238465
CountryCode: US
TelephoneNumber: 5174205973
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/02/2006
LastUpdateDate: 08/06/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X6801017211MIY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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