Healthcare Provider Details

I. General information

NPI: 1518820497
Provider Name (Legal Business Name): TODD BARLASS LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4776 WALKER RD
CLYDE MI
48049-3939
US

IV. Provider business mailing address

4776 WALKER RD
CLYDE MI
48049-3939
US

V. Phone/Fax

Practice location:
  • Phone: 810-334-6946
  • Fax:
Mailing address:
  • Phone: 810-334-6946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801084721
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: