MEDICARE: MS. SARAH MELISSA REISS 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	1041C0700X	Clinical Social Worker	6801086325	MI

General Provider Information

NPI Number	:	1417082306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARAH MELISSA REISS LMSW

Provider Business Mailing Address
First Line	:	555 TOWNER ST
Second Line	:	PO BOX 915
City	:	YPSILANTI
State	:	MI
Zip	:	48198-5752
Country	:	US
Telephone Number	:	734-544-3000
Fax Number	:	734-544-6732

Provider Business Practice Location Address
First Line	:	2201 HOGBACK RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48105-9732
Country	:	US
Telephone Number	:	734-544-3050
Fax Number	:	734-544-6732

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

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	09/23/2024

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