Healthcare Provider Details

I. General information

NPI: 1346176153
Provider Name (Legal Business Name): JILL ROCHELLE ANDERSON MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30671 STEPHENSON HWY STE C
MADISON HEIGHTS MI
48071-1652
US

IV. Provider business mailing address

575 S MAIN ST STE 6
PLYMOUTH MI
48170-1778
US

V. Phone/Fax

Practice location:
  • Phone: 248-850-1600
  • Fax: 248-850-1601
Mailing address:
  • Phone: 734-451-7800
  • Fax: 734-451-5410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: