MEDICARE: M. STEPHANIE SORBET 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
1	1041C0700X	Clinical Social Worker	6801081867	MI

General Provider Information

NPI Number	:	1316085491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	M. STEPHANIE SORBET LMSW

Provider Business Mailing Address
First Line	:	15231 PARIS ST
Second Line	:
City	:	ALLEN PARK
State	:	MI
Zip	:	48101-3513
Country	:	US
Telephone Number	:	313-388-8933
Fax Number	:

Provider Business Practice Location Address
First Line	:	1736 FORT ST
Second Line	:
City	:	LINCOLN PARK
State	:	MI
Zip	:	48146-1904
Country	:	US
Telephone Number	:	313-382-7861
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/08/2007

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