Provider Demographics
NPI:1235178153
Name:WOODS, JESSICA RAMSAY (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:RAMSAY
Last Name:WOODS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 CESAR E CHAVEZ AVE
Mailing Address - Street 2:SUITE B201
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-1094
Mailing Address - Country:US
Mailing Address - Phone:248-253-0176
Mailing Address - Fax:248-253-1570
Practice Address - Street 1:196 CESAR E CHAVEZ AVE
Practice Address - Street 2:SUITE B201
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-1094
Practice Address - Country:US
Practice Address - Phone:248-253-0176
Practice Address - Fax:248-253-1570
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010033031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q33899Medicare UPIN
MIN71680004Medicare ID - Type Unspecified