Healthcare Provider Details

I. General information

NPI: 1548790199
Provider Name (Legal Business Name): ANJANETTE MELISSA WILLIAMS-KENNEDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15140 LIVERNOIS AVE
DETROIT MI
48238-2045
US

IV. Provider business mailing address

15140 LIVERNOIS AVE
DETROIT MI
48238-2045
US

V. Phone/Fax

Practice location:
  • Phone: 313-600-4950
  • Fax:
Mailing address:
  • Phone: 313-600-4950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801120902
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: