Healthcare Provider Details

I. General information

NPI: 1275128894
Provider Name (Legal Business Name): LAJEAN PARTMON LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARKLANE BLVD STE 200E
DEARBORN MI
48126-2400
US

IV. Provider business mailing address

16800 EDINBOROUGH RD
DETROIT MI
48219-4036
US

V. Phone/Fax

Practice location:
  • Phone: 313-846-2606
  • Fax:
Mailing address:
  • Phone: 313-461-1003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801100072
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: