Healthcare Provider Details

I. General information

NPI: 1821861220
Provider Name (Legal Business Name): YUSENIA YASMINE HUERTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date: 04/26/2026
Reactivation Date: 05/26/2026

III. Provider practice location address

1332 PROSPECT AVE
CARO MI
48723-9288
US

IV. Provider business mailing address

1332 PROSPECT AVE
CARO MI
48723-9288
US

V. Phone/Fax

Practice location:
  • Phone: 989-673-6191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851122017
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: