Healthcare Provider Details

I. General information

NPI: 1770948903
Provider Name (Legal Business Name): MRS. HELEN CLAIRESE PAULSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HELEN CLAIRESE MARSACK

II. Dates (important events)

Enumeration Date: 12/14/2015
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 W BIG BEAVER RD STE 1450
TROY MI
48084-4762
US

IV. Provider business mailing address

4235 MANKATO AVE
ROYAL OAK MI
48073-1625
US

V. Phone/Fax

Practice location:
  • Phone: 248-244-8644
  • Fax:
Mailing address:
  • Phone: 586-554-0707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801098695
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801098695
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: