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General NPI Number Information
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NPI Number | 1700110566
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Entity Type | Individual
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Provider Name | MARY ANN SANDERS LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/28/2009
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Last Update Date | 09/28/2009
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Provider Practice Location Address
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Address Line | 9000 E JEFFERSON AVE APT 9-6
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City | DETROIT
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State | MI
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Zip | 48214-2962
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Country | US
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Telephone | 313-729-7641
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Fax | 313-729-7641
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Provider Business Mailing Address
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Address Line | 32231 SCHOOLCRAFT RD STE 210
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City | LIVONIA
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State | MI
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Zip | 48150-4322
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Country | US
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Telephone | 734-266-6800
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Fax | 734-266-6015
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 6801082384
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6801082384
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801082384
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 6801082384
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License Number State | MI
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