Provider Demographics
NPI:1629136262
Name:JOACHIM-SAM, CAROLEE ANN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLEE
Middle Name:ANN
Last Name:JOACHIM-SAM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:CAROLEE
Other - Middle Name:ANN
Other - Last Name:JOACHIM-SAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:9607 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:MI
Mailing Address - Zip Code:48001-4016
Mailing Address - Country:US
Mailing Address - Phone:810-794-7574
Mailing Address - Fax:810-794-7574
Practice Address - Street 1:44720 HAYES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-1087
Practice Address - Country:US
Practice Address - Phone:586-226-2922
Practice Address - Fax:586-228-1976
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801020678104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker