Provider Demographics
NPI:1659516797
Name:SAYES, AUDREY L (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:L
Last Name:SAYES
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 1:28740 MILTON AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-2367
Mailing Address - Country:US
Mailing Address - Phone:586-944-1432
Mailing Address - Fax:
Practice Address - Street 1:79 W ALEXANDRINE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2015
Practice Address - Country:US
Practice Address - Phone:313-531-5535
Practice Address - Fax:313-831-2608
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010913291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801091329OtherSTATE OF MICHIGAN BOARD OF SOCIAL WORK