Healthcare Provider Details

I. General information

NPI: 1245865526
Provider Name (Legal Business Name): JAN ULRICH MSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2020
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 HOGBACK RD STE 1A
ANN ARBOR MI
48105-9779
US

IV. Provider business mailing address

2010 HOGBACK RD STE 1A
ANN ARBOR MI
48105-9779
US

V. Phone/Fax

Practice location:
  • Phone: 734-709-4160
  • Fax:
Mailing address:
  • Phone: 734-709-4160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JAN CHRISTINE ULRICH
Title or Position: SOLE MEMBER / AUTHORIZED OFFICIAL
Credential: LMSW
Phone: 734-709-4160