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NPI Code Detail

MEDICARE: MS. NICOLE ERINN DEKKER LMSW

MEDICARE: MS. NICOLE ERINN DEKKER LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker6802087853MI

General Provider Information

NPI Number : 1225463367
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICOLE ERINN DEKKER LMSW
Provider Business Mailing Address
First Line : 870 NEW YORK AVE
Second Line :
City : LINCOLN PARK
State : MI
Zip : 48146-3155
Country : US
Telephone Number : 313-587-7428
Fax Number :
Provider Business Practice Location Address
First Line : 40 E FERRY ST
Second Line :
City : DETROIT
State : MI
Zip : 48202-3802
Country : US
Telephone Number : 734-785-7700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2013
Last Update Date : 08/07/2024

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