Provider Demographics
NPI:1629403068
Name:HUS, MARNI (LLMSW)
Entity Type:Individual
Prefix:MRS
First Name:MARNI
Middle Name:
Last Name:HUS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 OWANA AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3437
Mailing Address - Country:US
Mailing Address - Phone:248-505-0558
Mailing Address - Fax:
Practice Address - Street 1:9104 ALEXA DR
Practice Address - Street 2:
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48390-5813
Practice Address - Country:US
Practice Address - Phone:248-505-0558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010955771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801095577OtherLIMITED LICENSE MASTERS SOCIAL WORKER