Provider Demographics
NPI:1083004147
Name:WOOD, DANIEL WEBSTER CHRISTIAN (LMSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:WEBSTER CHRISTIAN
Last Name:WOOD
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 SPRING ARBOR RD STE 300
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-3652
Mailing Address - Country:US
Mailing Address - Phone:734-657-7343
Mailing Address - Fax:
Practice Address - Street 1:2575 SPRING ARBOR RD STE 300
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3652
Practice Address - Country:US
Practice Address - Phone:734-657-7343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010964451041C0700X
MI68011076951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical