MEDICARE: GINGER RADD BLAIR MSW

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	101YM0800X	Mental Health Counselor	6801035843	MI

General Provider Information

NPI Number	:	1821181975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINGER RADD BLAIR MSW

Provider Business Mailing Address
First Line	:	35458 RAVINE BLVD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48335-2470
Country	:	US
Telephone Number	:	313-415-1449
Fax Number	:

Provider Business Practice Location Address
First Line	:	4222 E MCNICHOLS RD STE A
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48212-1718
Country	:	US
Telephone Number	:	313-369-1717
Fax Number	:	313-369-1728

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	02/12/2026

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