Provider Demographics
NPI:1144234014
Name:KAROUGIAN-MOORE, Z.WENDY WENDY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:Z.WENDY
Middle Name:WENDY
Last Name:KAROUGIAN-MOORE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ZEPUR
Other - Middle Name:WENDY
Other - Last Name:KAROUGIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:29551 GREENFIELD RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2249
Mailing Address - Country:US
Mailing Address - Phone:248-443-4932
Mailing Address - Fax:248-443-4954
Practice Address - Street 1:29551 GREENFIELD RD
Practice Address - Street 2:SUITE 117
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2249
Practice Address - Country:US
Practice Address - Phone:248-443-4932
Practice Address - Fax:248-443-4954
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010183651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI124954OtherVALUE OPTIONS
MI7820276OtherAETNA
MI8008973840OtherBLUECRESS/BLUESHIELD
MI7820276OtherAETNA