Healthcare Provider Details

I. General information

NPI: 1407631559
Provider Name (Legal Business Name): MADALIN ROBERTS LLMSW, VSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10075 BERGIN RD STE C
HOWELL MI
48843-7049
US

IV. Provider business mailing address

10075 BERGIN RD STE C
HOWELL MI
48843-7049
US

V. Phone/Fax

Practice location:
  • Phone: 810-444-2484
  • Fax:
Mailing address:
  • Phone: 810-444-2484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851119536
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: