Provider Demographics
NPI:1295823128
Name:AMADI, PAUL OGBONNA (MSW LMSW ACSW CACI)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:OGBONNA
Last Name:AMADI
Suffix:
Gender:M
Credentials:MSW LMSW ACSW CACI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2313
Mailing Address - Street 2:1112 E 6TH STREET
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161
Mailing Address - Country:US
Mailing Address - Phone:734-244-7028
Mailing Address - Fax:734-244-7028
Practice Address - Street 1:1112 E 6TH STREET
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161
Practice Address - Country:US
Practice Address - Phone:734-244-7028
Practice Address - Fax:734-244-7028
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MII-03983101YA0400X
MI68010820631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical