Healthcare Provider Details

I. General information

NPI: 1386949097
Provider Name (Legal Business Name): JEAN RICHMAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2011
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2395 JOLLY RD STE 195
OKEMOS MI
48864-5987
US

IV. Provider business mailing address

2395 JOLLY RD STE 195
OKEMOS MI
48864-5987
US

V. Phone/Fax

Practice location:
  • Phone: 517-336-4335
  • Fax: 517-336-0101
Mailing address:
  • Phone: 517-336-4335
  • Fax: 517-336-0101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801090390
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: