Jerome X Avrushin, LMSW

Individual provider Active NPI Clinical Social Worker · Clarkston, MI

NPI 1851325815 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1851325815
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801011481 (MI)
Practice address
6770 Dixie Hwy
Suite 312
Clarkston, MI 48346-2087
Phone
(248) 922-2300
Fax
(248) 922-2304
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6801011481MIMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801011481 MI Yes

Addresses

Primary practice location

6770 Dixie Hwy
Suite 312
Clarkston, MI 48346-2087

Mailing address

7256 Creeks Bend CT
West Bloomfield, MI 48322-3523
Phone (248) 539-0639

Other providers in Clarkston, MI

All providers in Clarkston, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.