Provider Demographics
NPI:1497366900
Name:VERRETTE, JOREY (LLMSW)
Entity Type:Individual
Prefix:
First Name:JOREY
Middle Name:
Last Name:VERRETTE
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49412-1624
Mailing Address - Country:US
Mailing Address - Phone:231-923-8568
Mailing Address - Fax:
Practice Address - Street 1:106 S STEWART AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MI
Practice Address - Zip Code:49412-1624
Practice Address - Country:US
Practice Address - Phone:231-923-8568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801032551041C0700X
MI68011032551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical