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General NPI Number Information
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NPI Number | 1649602350
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Entity Type | Organization
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Legal Business Name | FAMILY SERVICE
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Dates
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Enumeration Date | 08/05/2013
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Last Update Date | 08/05/2013
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Provider Practice Location Address
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Address Line | 120 PARSONS ST
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City | DETROIT
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State | MI
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Zip | 48201-2002
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Country | US
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Telephone | 313-831-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 LAWNDALE ST
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City | DETROIT
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State | MI
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Zip | 48209-1727
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Country | US
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Telephone | 313-841-6254
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DEBORAH SNYDER
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Credential |
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Telephone | 248-990-4337
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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 | MI
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | MI
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Taxonomy #5
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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 | MI
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