Healthcare Provider Details

I. General information

NPI: 1821953118
Provider Name (Legal Business Name): NEURODIVERSE MICHIGAN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 SHELBY AVE STE 201D
ANN ARBOR MI
48103-3849
US

IV. Provider business mailing address

10773 KENICOTT TRL
BRIGHTON MI
48114-9075
US

V. Phone/Fax

Practice location:
  • Phone: 734-707-1303
  • Fax: 734-215-6952
Mailing address:
  • Phone: 734-707-1303
  • Fax: 734-215-6952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ANGELA CURTS
Title or Position: MEMBER
Credential: LMSW-CLINICAL AND MA
Phone: 734-707-1303