Healthcare Provider Details

I. General information

NPI: 1235918699
Provider Name (Legal Business Name): HYATT ALMARSOUMI LMSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 E BIG BEAVER RD STE 200
TROY MI
48083-1434
US

IV. Provider business mailing address

11761 GALLAGHER ST
HAMTRAMCK MI
48212-4108
US

V. Phone/Fax

Practice location:
  • Phone: 734-931-6133
  • Fax:
Mailing address:
  • Phone: 313-818-8895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801122492
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: