Provider Demographics
NPI:1366727836
Name:CRIPPS-LOONEY, CARMEN (MA,RAC)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:CRIPPS-LOONEY
Suffix:
Gender:F
Credentials:MA,RAC
Other - Prefix:
Other - First Name:CARMEN
Other - Middle Name:
Other - Last Name:LOONEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, RAC
Mailing Address - Street 1:901 CHIPPEWA ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-1552
Mailing Address - Country:US
Mailing Address - Phone:810-232-9950
Mailing Address - Fax:
Practice Address - Street 1:901 CHIPPEWA ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-1552
Practice Address - Country:US
Practice Address - Phone:810-232-9950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)