Provider Demographics
NPI:1528103272
Name:RORABACK, JANE E (MSW)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:E
Last Name:RORABACK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:RORABACK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW BCD
Mailing Address - Street 1:790 W LAKE LANSING RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8465
Mailing Address - Country:US
Mailing Address - Phone:517-332-3697
Mailing Address - Fax:517-332-9980
Practice Address - Street 1:790 W LAKE LANSING RD
Practice Address - Street 2:SUITE 300
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8465
Practice Address - Country:US
Practice Address - Phone:517-332-3697
Practice Address - Fax:517-332-9980
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801014591104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1P275136OtherMAGELLAN BEHAVIORAL HEALT
MI038595OtherVALUE OPTIONS
MI8008968480OtherBLUE CROSS BLUE SHIELD
6221030OtherUNITED BEHAVIORAL HEALTH
MI8008968480OtherBLUE CROSS BLUE SHIELD