Healthcare Provider Details

I. General information

NPI: 1699767533
Provider Name (Legal Business Name): JEWISH FAMILY SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6555 W MAPLE RD
WEST BLOOMFIELD MI
48322-4926
US

IV. Provider business mailing address

6555 W MAPLE RD
WEST BLOOMFIELD MI
48322-4926
US

V. Phone/Fax

Practice location:
  • Phone: 248-592-2300
  • Fax: 248-592-2326
Mailing address:
  • Phone: 248-592-2300
  • Fax: 248-592-2326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. NORMAN R KEANE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 248-592-2300