MEDICARE: MARETTA DEWITT

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	6851119423	MI

General Provider Information

NPI Number	:	1477412179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARETTA DEWITT

Provider Business Mailing Address
First Line	:	28475 GREENFIELD RD STE 113
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-3034
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	28475 GREENFIELD RD STE 113
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-3034
Country	:	US
Telephone Number	:	248-470-7287
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ MARETTA DEWITT ” Practice Location

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