Healthcare Provider Details

I. General information

NPI: 1700997152
Provider Name (Legal Business Name): JOELEE ANN BATEMAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26300 OUTER DR
LINCOLN PARK MI
48146-2019
US

IV. Provider business mailing address

26300 OUTER DR
LINCOLN PARK MI
48146-2019
US

V. Phone/Fax

Practice location:
  • Phone: 313-388-4360
  • Fax: 313-388-0472
Mailing address:
  • Phone: 313-388-4360
  • Fax: 313-388-0472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801062464
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: