Provider Demographics
NPI:1912877101
Name:LOOMIS, STEVE (INTERN)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:LOOMIS
Suffix:
Gender:M
Credentials:INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 SENECA DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-3866
Mailing Address - Country:US
Mailing Address - Phone:517-344-0913
Mailing Address - Fax:517-905-6007
Practice Address - Street 1:300 W WASHINGTON AVE STE 210B
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2160
Practice Address - Country:US
Practice Address - Phone:517-344-0913
Practice Address - Fax:517-905-6007
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-11
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty