Provider Demographics
NPI:1982392098
Name:STRUDWICK, DEANA (LMSW)
Entity type:Individual
Prefix:
First Name:DEANA
Middle Name:
Last Name:STRUDWICK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:DEANA
Other - Middle Name:
Other - Last Name:LOAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:19900 GRASS LAKE LN
Mailing Address - Street 2:
Mailing Address - City:WHITE PIGEON
Mailing Address - State:MI
Mailing Address - Zip Code:49099-8711
Mailing Address - Country:US
Mailing Address - Phone:269-625-1683
Mailing Address - Fax:
Practice Address - Street 1:677 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MI
Practice Address - Zip Code:49032-8525
Practice Address - Country:US
Practice Address - Phone:269-467-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical