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General NPI Number Information
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NPI Number | 1528374907
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Entity Type | Individual
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Provider Name | NANCY JEAN WILLIS LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 5060 JACKSON RD STE D
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City | ANN ARBOR
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State | MI
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Zip | 48103-1867
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Country | US
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Telephone | 734-627-8001
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Fax | 734-433-1989
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Provider Business Mailing Address
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Address Line | 5060 JACKSON RD STE D
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City | ANN ARBOR
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State | MI
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Zip | 48103-1867
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Country | US
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Telephone | 734-627-8001
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Fax | 734-433-1989
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6801117431
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | M-07172
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 081889-1
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License Number State | NY
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