Provider Demographics
NPI:1760718605
Name:SAWICKI, TEENA MARIE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:TEENA
Middle Name:MARIE
Last Name:SAWICKI
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 1:1868 CORA ST
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-3924
Mailing Address - Country:US
Mailing Address - Phone:734-284-7784
Mailing Address - Fax:
Practice Address - Street 1:3501 HAMTRAMCK DR
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48211-1400
Practice Address - Country:US
Practice Address - Phone:313-875-7121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010774331041C0700X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251S00000XAgenciesCommunity/Behavioral Health