Healthcare Provider Details

I. General information

NPI: 1538833223
Provider Name (Legal Business Name): NOAH KAZDAN BIZER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N CENTER ST STE 204
NORTHVILLE MI
48167-1495
US

IV. Provider business mailing address

1407 CHARLTON AVE
ANN ARBOR MI
48103-4165
US

V. Phone/Fax

Practice location:
  • Phone: 248-880-7072
  • Fax:
Mailing address:
  • Phone: 248-880-7072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801117636
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: