Healthcare Provider Details

I. General information

NPI: 1699172098
Provider Name (Legal Business Name): SARAH ADKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2014
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 SYCAMORE ST
WYANDOTTE MI
48192-5849
US

IV. Provider business mailing address

15700 W 10 MILE RD STE 106
SOUTHFIELD MI
48075-2100
US

V. Phone/Fax

Practice location:
  • Phone: 734-365-9218
  • Fax:
Mailing address:
  • Phone: 248-241-6772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number680109509
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801095092
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: