Individual provider Active NPI

Mianne Afua Adufutse, LMT

  • Social Worker
  • Sterling Heights, MI
National Provider Identifier
1417553140
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
43241 Cambridge Dr
Sterling Heights, MI 48313-1812
Phone
(305) 924-0303
NPI assigned
Dec 8, 2020
Reactivated
Mar 9, 2023
Last updated
Sep 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU Primary
Massage Therapist 225700000X 7501005970 MI

Addresses

Primary practice location

43241 Cambridge Dr
Sterling Heights, MI 48313-1812

Mailing address

43241 Cambridge Dr
Sterling Heights, MI 48313-1812
Phone (305) 924-0303

Other practice location 1

G3169 Beecher Rd
Flint, MI 48532-3611
Phone (616) 301-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7501005970MIMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1417553140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43241 CAMBRIDGE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131812",
            "telephone_number": "305-924-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43241 CAMBRIDGE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131812",
            "telephone_number": "305-924-0303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "G3169 Beecher Rd",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485323611",
            "country_code": "US",
            "telephone_number": "616-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADUFUTSE",
        "first_name": "MIANNE",
        "middle_name": "AFUA",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "deactivation_date": "2021-02-25",
        "reactivation_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501005970",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.