Healthcare Provider Details

I. General information

NPI: 1245140037
Provider Name (Legal Business Name): SOPHIE GURIZZIAN LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44644 ANN ARBOR RD W STE C
PLYMOUTH MI
48170-4093
US

IV. Provider business mailing address

5750 BARNHART RD
LUDINGTON MI
49431-8693
US

V. Phone/Fax

Practice location:
  • Phone: 313-444-6720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851122835
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: