Mynesha Avery, BSW, LLBSW
Individual provider Active NPI Case Manager/Care Coordinator · Wayne, MI
NPI 1669019147 · NPPES record last updated Dec 4, 2019
Key facts
- NPI
- 1669019147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- 6802090567 (MI)
- Practice address
- 35425 W Michigan Ave Ste 1
Wayne, MI 48184-1600 - Phone
- (734) 722-4686
- Fax
- (734) 467-7646
- NPI assigned
- Dec 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802090567 | MI | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 6802090567 | MI | Yes |
Addresses
Primary practice location
35425 W Michigan Ave Ste 1
Wayne, MI 48184-1600
Mailing address
35425 W Michigan Ave Ste 1
Wayne, MI 48184-1600
Phone (734) 722-4686
Other providers in Wayne, MI
- Arshi Care, Inc.
- Monika Assenov
- Astercare Home Health LLC
- Astoria Medical P C
- Aysha Athar
- Mahmoud Awada
- Josephine Axiak
- Saleem Azad
- Suraiya Khanom Azom
- Lena Azzam
All providers in Wayne, MI · Case Manager/Care Coordinator in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.