Provider Demographics
NPI:1558724112
Name:SVIDLER, MARIA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:SVIDLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:MIRIAM
Other - Middle Name:
Other - Last Name:SVIDLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:17177 N LAUREL PARK DR
Mailing Address - Street 2:SUITE #131
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-2693
Mailing Address - Country:US
Mailing Address - Phone:734-462-3210
Mailing Address - Fax:
Practice Address - Street 1:17177 N LAUREL PARK DR
Practice Address - Street 2:SUITE #131
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2693
Practice Address - Country:US
Practice Address - Phone:734-462-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010952171041C0700X
NY089243-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical