MEDICARE: KHADIJAH MUTAKABBIR

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	6851117885	MI

General Provider Information

NPI Number	:	1831920917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHADIJAH MUTAKABBIR

Provider Business Mailing Address
First Line	:	2200 HUNT ST STE 402
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207-5600
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22511 TELEGRAPH RD STE 215
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-4108
Country	:	US
Telephone Number	:	248-809-2051
Fax Number	:

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

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

Similar Medicare Providers

1740428820 — MRS. REBECCA CANDACE SHELTON-WILLIAMS LMSW
Practice Location Address:

22511 TELEGRAPH RD STE 101
SOUTHFIELD, MI
48033-4108

Practice Phone: 248-356-0540
Practice Fax: 248-356-0539

1497114995 — DR. SAMONE RENEE MARION PHD
Practice Location Address:

22511 TELEGRAPH RD STE 215A
SOUTHFIELD, MI
48033-4108

Practice Phone: 248-809-2051
Practice Fax: 248-996-8384

1518619980 — FREE SPIRIT HOSPICE CARE, LLC
Practice Location Address:

22511 TELEGRAPH RD STE 214
SOUTHFIELD, MI
48033-4108

Practice Phone: 248-973-7336
Practice Fax:

1225786601 — COMFORT HOSPICE CARE LLC
Practice Location Address:

22511 TELEGRAPH RD STE 214
SOUTHFIELD, MI
48033-4108

Practice Phone: 248-973-7336
Practice Fax: 248-856-9348

1013770718 — AARISS COMPANY
Practice Location Address:

22511 TELEGRAPH RD STE 222
SOUTHFIELD, MI
48033-4108

Practice Phone: 313-314-3309
Practice Fax:

1790585404 — WENDY MICHELLE DAVIS BSW, LLMSW
Practice Location Address:

22511 TELEGRAPH RD STE 222
SOUTHFIELD, MI
48033-4108

Practice Phone: 248-598-2297
Practice Fax:

Directions to “ KHADIJAH MUTAKABBIR ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.