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Clinical Social Worker · Dearborn, MI
At a glance
5275 Kenilworth St, Dearborn, MI 48126-3197
NPPES record updated Jul 2, 2026. Public records can lag behind changes at a practice.
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Practice location
5275 Kenilworth StDearborn, MI 48126-3197
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Clinical Social Worker
- Taxonomy code
- 1041C0700X
- Enumeration date
- Oct 2, 2018
- Record updated
- Jul 2, 2026
More registry details
- Provider type
- Organization · Type 2
Reported taxonomies and licenses
Clinical Social Worker
1041C0700X · Primary
Specialty details in registry
251S00000X
Specialty details in registry
252Y00000X
Specialty details in registry
261QC1500X
Specialty details in registry
261QM0855X
Specialty details in registry
261QP0905X
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
5275 Kenilworth StDearborn, MI 48126-3197
- Phone
- (313) 846-8480
- Fax
- (313) 846-2710
Mailing address
5275 KENILWORTH STDEARBORN, MI 481263197
Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.
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