Individual provider Active NPI

Julliette M Mahfouz, LLMSW

  • Clinical Social Worker
  • Dearborn, MI
National Provider Identifier
1881264125
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851120597 Issued in MI
Practice address
19853 Outer Dr Ste 110
Dearborn, MI 48124-2044
Phone
(313) 406-5056
Fax
(248) 712-4381
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6851120597 MI Primary

Addresses

Primary practice location

19853 Outer Dr Ste 110
Dearborn, MI 48124-2044

Mailing address

2200 N Canton Center Rd Ste 200a
Canton, MI 48187-5038

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

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1881264125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 N CANTON CENTER RD STE 200A",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19853 OUTER DR STE 110",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242044",
            "telephone_number": "313-406-5056",
            "fax_number": "248-712-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHFOUZ",
        "first_name": "JULLIETTE",
        "middle_name": "M",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851120597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.