Provider Demographics
NPI:1306249610
Name:AGUIRRE, RAFAEL PARSONS (LMSW)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:PARSONS
Last Name:AGUIRRE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16523 S WATER TOWER DR
Mailing Address - Street 2:
Mailing Address - City:KINCHELOE
Mailing Address - State:MI
Mailing Address - Zip Code:49788-1592
Mailing Address - Country:US
Mailing Address - Phone:906-495-2020
Mailing Address - Fax:906-495-1093
Practice Address - Street 1:16523 S WATER TOWER DR
Practice Address - Street 2:
Practice Address - City:KINCHELOE
Practice Address - State:MI
Practice Address - Zip Code:49788-1592
Practice Address - Country:US
Practice Address - Phone:906-495-2020
Practice Address - Fax:906-495-1093
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010940061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical