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General NPI Number Information
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NPI Number | 1043488018
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Entity Type | Organization
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Legal Business Name | SMITH CANNADY COUNSELING ASSOCIATES INC
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 15659 W 10 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2188
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Country | US
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Telephone | 248-569-4290
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Fax | 248-569-0609
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Provider Business Mailing Address
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Address Line | 15659 W 10 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2188
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Country | US
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Telephone | 248-569-4290
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Fax | 248-569-0609
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Authorized Official
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Title or Position | PRESIDENT
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Name | MONTRESSIA E SMITH-CANNADY
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Credential | MSW
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Telephone | 248-569-4290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801001488
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License Number State | MI
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