Healthcare Provider Details

I. General information

NPI: 1760399356
Provider Name (Legal Business Name): AARON LADOUCEUR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1385 MAHAFFY AVE
ROCHESTER HILLS MI
48307-1507
US

IV. Provider business mailing address

1385 MAHAFFY AVE
ROCHESTER HILLS MI
48307-1507
US

V. Phone/Fax

Practice location:
  • Phone: 248-726-6961
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6851121020
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: