MEDICARE: MOHAMMAD HANIF LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	6801019810	MI
2	1041C0700X	Clinical Social Worker	6801019810	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6801019810	OTHER	MI	SOCIAL WORKER

General Provider Information

NPI Number	:	1114976503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMMAD HANIF LMSW

Provider Business Mailing Address
First Line	:	1980 KRISTIN DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-1425
Country	:	US
Telephone Number	:	248-649-5544
Fax Number	:	248-649-5544

Provider Business Practice Location Address
First Line	:	1980 KRISTIN DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-1425
Country	:	US
Telephone Number	:	248-649-5544
Fax Number	:	248-649-5544

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	06/04/2021

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