Healthcare Provider Details

I. General information

NPI: 1154230092
Provider Name (Legal Business Name): SAMANTHA WEFEL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 N FRANKLIN ST STE B
FRANKENMUTH MI
48734-1154
US

IV. Provider business mailing address

1062 E HURD RD
CLIO MI
48420-7900
US

V. Phone/Fax

Practice location:
  • Phone: 989-480-3235
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801122958
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801122958
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: