Provider Demographics
NPI:1023355518
Name:PAPE, DEANNE KAY (LMSW)
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:KAY
Last Name:PAPE
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 1:615 E CROSSTOWN PKWY
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-2501
Mailing Address - Country:US
Mailing Address - Phone:269-553-7148
Mailing Address - Fax:269-373-4951
Practice Address - Street 1:615 E CROSSTOWN PKWY
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001
Practice Address - Country:US
Practice Address - Phone:269-553-7148
Practice Address - Fax:269-373-4159
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010943141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical