Provider Demographics
NPI:1417055195
Name:DEVORE, JEFFREY (MSW,LMSW,ACSW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:DEVORE
Suffix:
Gender:M
Credentials:MSW,LMSW,ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15420 19 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6339
Mailing Address - Country:US
Mailing Address - Phone:586-226-7007
Mailing Address - Fax:586-226-7033
Practice Address - Street 1:15420 19 MILE RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6339
Practice Address - Country:US
Practice Address - Phone:586-226-7007
Practice Address - Fax:586-226-7007
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical