Provider Demographics
NPI:1083193882
Name:LLOYD, COREY SUSAN (MSW, LMSW)
Entity type:Individual
Prefix:MISS
First Name:COREY
Middle Name:SUSAN
Last Name:LLOYD
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:MRS
Other - First Name:COREY
Other - Middle Name:SUSAN LLOYD
Other - Last Name:PARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:238 HOOVER BLVD STE 30
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3782
Mailing Address - Country:US
Mailing Address - Phone:616-312-2989
Mailing Address - Fax:616-294-4202
Practice Address - Street 1:238 HOOVER BLVD STE 30
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3782
Practice Address - Country:US
Practice Address - Phone:616-312-2989
Practice Address - Fax:616-294-4202
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801110245104100000X
MI68011173361041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical