Healthcare Provider Details

I. General information

NPI: 1245775816
Provider Name (Legal Business Name): MELONIE ELORA HOBBS LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2017
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13336 E WARREN AVE
DETROIT MI
48215-2112
US

IV. Provider business mailing address

36750 HARPER AVE
CLINTON TOWNSHIP MI
48035-5881
US

V. Phone/Fax

Practice location:
  • Phone: 313-822-6940
  • Fax:
Mailing address:
  • Phone: 248-796-2445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6851105642
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: