Healthcare Provider Details

I. General information

NPI: 1952978983
Provider Name (Legal Business Name): BROOKE DANIELLE LEFEVRE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 12/07/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 AXTELL DR
TROY MI
48084-4404
US

IV. Provider business mailing address

1777 AXTELL DR
TROY MI
48084-4404
US

V. Phone/Fax

Practice location:
  • Phone: 248-862-1171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801109369
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: