Provider Demographics
NPI:1518252923
Name:CASS, MICHELLE L
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:L
Last Name:CASS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42790 GEORGETOWN
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1767
Mailing Address - Country:US
Mailing Address - Phone:313-585-1329
Mailing Address - Fax:
Practice Address - Street 1:22214 SOLOMON BLVD
Practice Address - Street 2:APT 135
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-5073
Practice Address - Country:US
Practice Address - Phone:313-585-1329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI680308619101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)