Provider Demographics
NPI:1740790625
Name:POTJE, STEVEN (MSW)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:POTJE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7177 MILLER DR STE C
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-1699
Mailing Address - Country:US
Mailing Address - Phone:586-273-3212
Mailing Address - Fax:
Practice Address - Street 1:7177 MILLER DR STE C
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-1699
Practice Address - Country:US
Practice Address - Phone:586-273-3212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010132231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical