Provider Demographics
NPI:1225260763
Name:STEIN, MARCIA B (MSW)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:B
Last Name:STEIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30445 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 360
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3158
Mailing Address - Country:US
Mailing Address - Phone:248-539-3804
Mailing Address - Fax:
Practice Address - Street 1:30445 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 360
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3158
Practice Address - Country:US
Practice Address - Phone:248-539-3804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801020405104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker