Provider Demographics
NPI:1437375458
Name:KROOPNICK, MAURY AARON (LMSW)
Entity Type:Individual
Prefix:MR
First Name:MAURY
Middle Name:AARON
Last Name:KROOPNICK
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 PARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-5109
Mailing Address - Country:US
Mailing Address - Phone:734-975-4671
Mailing Address - Fax:
Practice Address - Street 1:220 BAGLEY ST STE 1100
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-1411
Practice Address - Country:US
Practice Address - Phone:313-961-7990
Practice Address - Fax:313-961-6274
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010170021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical