Healthcare Provider Details

I. General information

NPI: 1902310311
Provider Name (Legal Business Name): ELIZABETH JAMROS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 FORT ST
TRENTON MI
48183-2003
US

IV. Provider business mailing address

1466 E HAYES AVE
HAZEL PARK MI
48030-2623
US

V. Phone/Fax

Practice location:
  • Phone: 734-304-4159
  • Fax:
Mailing address:
  • Phone: 810-623-7381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801093808
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: