Healthcare Provider Details

I. General information

NPI: 1932456076
Provider Name (Legal Business Name): LEONARD O UCHENDU LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4197 BLACK CHERRY LN
MASON MI
48854-8318
US

IV. Provider business mailing address

4197 BLACK CHERRY LN
MASON MI
48854-8318
US

V. Phone/Fax

Practice location:
  • Phone: 517-325-3688
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801094635
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: