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General NPI Number Information
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NPI Number | 1568032837
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Entity Type | Organization
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Legal Business Name | FOSTERING FUTURES
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 2008 HOGBACK RD STE 6
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City | ANN ARBOR
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State | MI
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Zip | 48105-9751
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Country | US
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Telephone | 734-481-8999
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Fax | 734-369-3291
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Provider Business Mailing Address
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Address Line | 2008 HOGBACK RD STE 6
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City | ANN ARBOR
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State | MI
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Zip | 48105-9751
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Country | US
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Telephone | 734-481-8999
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Fax | 734-369-3291
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JENNIFER C DEVIVO
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Credential | LMSW
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Telephone | 734-864-6879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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