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General NPI Number Information
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NPI Number | 1154477859
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Entity Type | Organization
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Legal Business Name | NATIONAL COUNCIL ON ALCOHOLISM & DRUG DEPENDENCE GREATER DETROIT
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 12/19/2017
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Provider Practice Location Address
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Address Line | 16647 WYOMING
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City | DETROIT
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State | MI
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Zip | 48221
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Country | US
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Telephone | 313-342-3606
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Fax | 313-861-0413
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Provider Business Mailing Address
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Address Line | 16647 WYOMING
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City | DETROIT
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State | MI
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Zip | 48221
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Country | US
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Telephone | 313-342-3606
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Fax | 313-861-0413
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. LINDA WOODWARD
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Credential | LMSW ASCW
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Telephone | 313-342-3606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | SA0821863
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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