Provider Demographics
NPI:1225153463
Name:WOJAHN, JAMIE A (LPC, CAADC, ICAADC)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:A
Last Name:WOJAHN
Suffix:
Gender:F
Credentials:LPC, CAADC, ICAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2202
Mailing Address - Country:US
Mailing Address - Phone:313-832-3100
Mailing Address - Fax:
Practice Address - Street 1:3430 3RD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2202
Practice Address - Country:US
Practice Address - Phone:313-832-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011251101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor