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General NPI Number Information
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NPI Number | 1972161727
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Entity Type | Organization
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Legal Business Name | ASSOCIATED CLINICIANS OF MICHIGAN LLC
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 30521 SCHOENHERR RD STE 200
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City | WARREN
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State | MI
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Zip | 48088
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Country | US
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Telephone | 313-404-1195
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Fax |
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Provider Business Mailing Address
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Address Line | 30521 SCHOENHERR RD STE 200
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City | WARREN
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State | MI
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Zip | 48088-3161
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Country | US
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Telephone | 313-404-1195
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF SOCIAL WORK
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Name | JANE BAYS
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Credential | LMSW, CAADC
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Telephone | 248-690-6450
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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