=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265320592
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRANDON MICHAEL STENGER LLMSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2025
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6773 W MAPLE RD
-----------------------------------------------------
City | WEST BLOOMFIELD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48322-3030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-788-3033
-----------------------------------------------------
Fax | 313-916-3917
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 FORD PL STE 3A
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48202-3450
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-874-4806
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 6851119623
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------