Healthcare Provider Details

I. General information

NPI: 1093077158
Provider Name (Legal Business Name): MARIA AMELIA MENOZZI LMFT, CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31235 HARPER AVE STE 276
SAINT CLAIR SHORES MI
48082-1425
US

IV. Provider business mailing address

29317 GREATER MACK AVE
SAINT CLAIR SHORES MI
48081-1227
US

V. Phone/Fax

Practice location:
  • Phone: 586-777-3132
  • Fax:
Mailing address:
  • Phone: 586-777-3132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4101006595
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC-02929
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: