Provider Demographics
NPI:1568732329
Name:SUTTON, MARY FRANCES (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:FRANCES
Last Name:SUTTON
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 1:10714 BORGMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1107
Mailing Address - Country:US
Mailing Address - Phone:248-542-1236
Mailing Address - Fax:
Practice Address - Street 1:26789 WOODWARD AVE
Practice Address - Street 2:208
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1335
Practice Address - Country:US
Practice Address - Phone:248-514-5187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010092331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical