Provider Demographics
NPI:1558530493
Name:ALFORD, BRANDON ALLEN (LMSW)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:ALLEN
Last Name:ALFORD
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 1:4880 LAWNDALE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48210-2010
Mailing Address - Country:US
Mailing Address - Phone:313-846-6030
Mailing Address - Fax:313-846-2751
Practice Address - Street 1:39000 7 MILE RD STE 2300
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1006
Practice Address - Country:US
Practice Address - Phone:734-292-8589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010975411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical