Provider Demographics
NPI:1477607216
Name:FOY, KHALEA DORIONNE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KHALEA
Middle Name:DORIONNE
Last Name:FOY
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 1:6121 HECLA ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48208-1335
Mailing Address - Country:US
Mailing Address - Phone:313-531-2500
Mailing Address - Fax:313-255-3471
Practice Address - Street 1:17321 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-3132
Practice Address - Country:US
Practice Address - Phone:313-531-2500
Practice Address - Fax:313-255-3471
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010824271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIKF082427OtherBCBS PIN