Healthcare Provider Details

I. General information

NPI: 1558470666
Provider Name (Legal Business Name): PATRICIA LIRIA VULPE MSW,LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 S WEST ST STE 150
ROYAL OAK MI
48067-2521
US

IV. Provider business mailing address

415 S WEST ST STE 150
ROYAL OAK MI
48067-2521
US

V. Phone/Fax

Practice location:
  • Phone: 248-546-6432
  • Fax: 248-546-8070
Mailing address:
  • Phone: 248-546-6432
  • Fax: 248-546-8070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801013046
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: