=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912102765
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY MARIE HOSKIN LBSW, LLPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2007
-----------------------------------------------------
Last Update Date | 06/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24500 FORD RD
-----------------------------------------------------
City | DEARBORN HEIGHTS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48127-3182
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-655-0051
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21167 COUNTRY CLUB DR
-----------------------------------------------------
City | HARPER WOODS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48225-1609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-480-3962
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 6451024339
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------