Provider Demographics
NPI:1760804447
Name:HUFF, RISARG (LMSW)
Entity Type:Individual
Prefix:
First Name:RISARG
Middle Name:
Last Name:HUFF
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3866 AUDUBON RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2749
Mailing Address - Country:US
Mailing Address - Phone:313-832-3100
Mailing Address - Fax:313-832-5271
Practice Address - Street 1:3430 3RD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2202
Practice Address - Country:US
Practice Address - Phone:313-832-3100
Practice Address - Fax:313-832-5271
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010636091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical