Provider Demographics
NPI:1194467290
Name:NIGHT, JAMIE ANNE (LLMSW)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:ANNE
Last Name:NIGHT
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 VANTAGE TER APT 106
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-1263
Mailing Address - Country:US
Mailing Address - Phone:631-806-2878
Mailing Address - Fax:
Practice Address - Street 1:28592 ORCHARD LAKE RD STE 390
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2903
Practice Address - Country:US
Practice Address - Phone:248-296-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851113946104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker