Provider Demographics
NPI:1457304610
Name:HOUGH, DAVID R (MSW, ACSW, DCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:R
Last Name:HOUGH
Suffix:
Gender:M
Credentials:MSW, ACSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 NORTH OLD WOODWARD AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-5392
Mailing Address - Country:US
Mailing Address - Phone:248-644-8783
Mailing Address - Fax:248-644-3322
Practice Address - Street 1:280 NORTH OLD WOODWARD AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-5392
Practice Address - Country:US
Practice Address - Phone:248-644-8783
Practice Address - Fax:248-644-3322
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010202901041C0700X
MI4101005400106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4101005400OtherLIC. MARRIAGE & FAMILY TH
MI6801020290OtherMASTER SW CLIN/MACRO LIC.
MI4101005400OtherLIC. MARRIAGE & FAMILY TH