Provider Demographics
NPI:1528572880
Name:ESSENMACHER, MICHAEL ALLEN
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALLEN
Last Name:ESSENMACHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4224
Mailing Address - Country:US
Mailing Address - Phone:989-797-3400
Mailing Address - Fax:989-754-7829
Practice Address - Street 1:500 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4224
Practice Address - Country:US
Practice Address - Phone:989-797-3400
Practice Address - Fax:989-754-7829
Is Sole Proprietor?:No
Enumeration Date:2017-11-24
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511173191041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical