Healthcare Provider Details

I. General information

NPI: 1073545976
Provider Name (Legal Business Name): HELEN L POPE LMSW, CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HELEN L BROECKER

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 12/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45660 SCHOENHERR RD
SHELBY TOWNSHIP MI
48315-6033
US

IV. Provider business mailing address

28000 DEQUINDRE RD
WARREN MI
48092-2468
US

V. Phone/Fax

Practice location:
  • Phone: 586-566-3020
  • Fax: 586-566-3055
Mailing address:
  • Phone: 586-753-0400
  • Fax: 586-753-3896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801063929
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: