MEDICARE: I AM-WELLNESS GROUP LLC

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	6801098588	MI

General Provider Information

NPI Number	:	1518461532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I AM-WELLNESS GROUP LLC

Provider Business Mailing Address
First Line	:	31185 WHITE OAK DR
Second Line	:
City	:	CHESTERFIELD
State	:	MI
Zip	:	48047-5700
Country	:	US
Telephone Number	:	586-215-6534
Fax Number	:

Provider Business Practice Location Address
First Line	:	51424 VAN DYKE AVE STE 23
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48316-4409
Country	:	US
Telephone Number	:	586-215-6534
Fax Number	:

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	MR. SCOTT MICHAEL STEENBERGH
Credential	:	MSW, LMSW, CAADC
Telephone Number	:	586-215-6534

Provider Enumeration Date	:	03/23/2018
Last Update Date	:	03/23/2018

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