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General NPI Number Information
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NPI Number | 1841019858
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Entity Type | Individual
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Provider Name | DEON D. WARREN JR. LLMSW
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Gender | Male
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 418 W KALAMAZOO AVE
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City | KALAMAZOO
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State | MI
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Zip | 49007-3334
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Country | US
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Telephone | 269-491-5439
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Fax |
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Provider Business Mailing Address
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Address Line | 3421 FAWN COVE LN APT 5
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City | PORTAGE
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State | MI
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Zip | 49024-4797
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Country | US
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Telephone | 517-763-7157
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6851118941
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License Number State | MI
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