Healthcare Provider Details

I. General information

NPI: 1609353531
Provider Name (Legal Business Name): SEKAI K. WARD - THERAPY THAT FIST YOUR LIFESTYLE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2217 PACKARD ST STE 16A
ANN ARBOR MI
48104-5702
US

IV. Provider business mailing address

3221 LOCKRIDGE ST
ANN ARBOR MI
48108-1721
US

V. Phone/Fax

Practice location:
  • Phone: 734-678-7802
  • Fax:
Mailing address:
  • Phone: 734-678-7802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801089732
License Number StateMI

VIII. Authorized Official

Name: SEKAI K WARD
Title or Position: PROVIDER/OWNER
Credential: LMSW
Phone: 734-678-7802