MEDICARE: STEP FORWARD

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	1041C0700X	Clinical Social Worker	6801032874	MI

General Provider Information

NPI Number	:	1174951693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEP FORWARD

Provider Business Mailing Address
First Line	:	41800 HAYES RD STE 206
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48038-1876
Country	:	US
Telephone Number	:	586-718-4714
Fax Number	:

Provider Business Practice Location Address
First Line	:	41800 HAYES RD STE 206
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48038-1876
Country	:	US
Telephone Number	:	586-718-4714
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	SUZANNE MARIE JOHNSON
Credential	:	LMSW
Telephone Number	:	586-718-4714

Provider Enumeration Date	:	10/18/2013
Last Update Date	:	11/09/2023

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Directions to “STEP FORWARD ” Practice Location

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