Provider Demographics
NPI:1154462075
Name:SOBCZYNSKI, JAMES (NMN) (LMSW, ACSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:(NMN)
Last Name:SOBCZYNSKI
Suffix:
Gender:M
Credentials:LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25924 HARMON ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-2137
Mailing Address - Country:US
Mailing Address - Phone:586-779-9679
Mailing Address - Fax:586-274-0228
Practice Address - Street 1:3701 E 13 MILE RD
Practice Address - Street 2:SUITE B
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-3795
Practice Address - Country:US
Practice Address - Phone:586-274-0200
Practice Address - Fax:586-274-0228
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010188841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical