Individual provider · NPI-1

Jessica Andreasen, LMSW

Social Worker, Clinical · Saint Clair Shores, MI

NPI number1699137620
StatusActive
Last updated in NPPESOct 10, 2023

Details

NPI
1699137620
Entity type
Individual (NPI-1)
Name
Jessica Andreasen
Credential
LMSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 29, 2016
Certification date
Oct 5, 2023
Last updated
Oct 10, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical6801092867MIYes
104100000X Social Worker6801092867MI

Practice location

23100 Jefferson Ave
Saint Clair Shores, MI 48080-2756

Phone 586-335-2006 · Fax 586-279-3886

Mailing address

1114 Saint Aubin Pl
Detroit, MI 48207-3816

Phone 248-568-0538

Other practice locations

2051 W Grand Blvd
Detroit, MI 48208-1105

Phone 313-961-3221

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