Individual provider · NPI-1

Michael Anderson, CHW

Community Health Worker · Detroit, MI

NPI number1629963889
StatusActive
Last updated in NPPESJun 10, 2025

Details

NPI
1629963889
Entity type
Individual (NPI-1)
Name
Michael Anderson
Credential
CHW
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 10, 2025
Certification date
Jun 5, 2025
Last updated
Jun 10, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172V00000X Community Health Worker––Yes
101Y00000X Counselor––

Practice location

1 Ford Pl
Detroit, MI 48202-3450

Phone 313-480-7192

Mailing address

1 Ford Pl
Detroit, MI 48202-3450

Phone 313-480-7192

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