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General NPI Number Information
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NPI Number | 1942962410
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Entity Type | Individual
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Provider Name | MICHELLE K YORK LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/12/2021
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 3111 GRAND RIVER AVE
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City | DETROIT
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State | MI
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Zip | 48208-2962
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Country | US
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Telephone | 313-577-8610
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Fax | 313-456-9601
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Provider Business Mailing Address
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Address Line | 45595 TIMBERLANE CT APT 202
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City | NOVI
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State | MI
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Zip | 48377-1142
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Country | US
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Telephone | 248-207-8219
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801098255
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License Number State | MI
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