MEDICARE: ANTASIA MADDOX LMSW-C

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	6801121406	MI

General Provider Information

NPI Number	:	1659088870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTASIA MADDOX LMSW-C

Provider Business Mailing Address
First Line	:	124 PEARL ST STE 503
Second Line	:
City	:	YPSILANTI
State	:	MI
Zip	:	48197-2663
Country	:	US
Telephone Number	:	734-620-1935
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 PEARL ST STE 503
Second Line	:
City	:	YPSILANTI
State	:	MI
Zip	:	48197-2663
Country	:	US
Telephone Number	:	734-620-1936
Fax Number	:

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

Provider Enumeration Date	:	10/28/2022
Last Update Date	:	12/11/2025

Similar Medicare Providers

1174059810 — MISS BREANNAH NIKORA
Practice Location Address:

124 PEARL ST
YPSILANTI, MI
48197-2663

Practice Phone: 734-945-6210
Practice Fax: 734-822-0119

1811954415 — DR. WALTER ERIC PHILLIPS D.D.S.
Practice Location Address:

124 PEARL ST , SUITE 207
YPSILANTI, MI
48197-2663

Practice Phone: 734-481-0180
Practice Fax: 734-481-1087

1164533204 — YPSILANTI FAMILY & COSMETIC DENTISTRY
Practice Location Address:

124 PEARL ST , STE 207
YPSILANTI, MI
48197-2663

Practice Phone: 734-481-0180
Practice Fax: 734-481-1087

1851511760 — CBC SERVICES LLC
Practice Location Address:

124 PEARL ST , SUITE 308
YPSILANTI, MI
48197-2663

Practice Phone: 734-485-8527
Practice Fax: 734-629-0563

1700040110 — CELESTINE A SANDERS CSW
Practice Location Address:

124 PEARL ST , SUITE 308
YPSILANTI, MI
48197-2663

Practice Phone: 734-485-8527
Practice Fax: 734-629-0563

1790934271 — DIANA M PARRISH LMSW
Practice Location Address:

124 PEARL ST STE 404
YPSILANTI, MI
48197-2663

Practice Phone: 734-210-0830
Practice Fax:

Directions to “ ANTASIA MADDOX LMSW-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.