Healthcare Provider Details

I. General information

NPI: 1710850987
Provider Name (Legal Business Name): ADAM LAURENCE KLEMZ LLMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 19 MILE RD
CLINTON TWP MI
48038-3502
US

IV. Provider business mailing address

16057 DURELL DR
MACOMB MI
48044-2555
US

V. Phone/Fax

Practice location:
  • Phone: 586-263-8700
  • Fax:
Mailing address:
  • Phone: 586-263-8700
  • Fax: 248-475-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851115376
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: