MEDICARE: MS. KAMILAH SELE OMARI LMSW-C&M

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	6801086071	MI
2	101YM0800X	Mental Health Counselor	6801086071	MI

General Provider Information

NPI Number	:	1588849194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAMILAH SELE OMARI LMSW-C&M

Provider Business Mailing Address
First Line	:	10201 E JEFFERSON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48214-3149
Country	:	US
Telephone Number	:	888-813-8326
Fax Number	:

Provider Business Practice Location Address
First Line	:	10201 E JEFFERSON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48214-3149
Country	:	US
Telephone Number	:	888-813-8326
Fax Number	:

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

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	07/14/2025

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