Provider Demographics
NPI:1811013303
Name:SUMPTER, KAREN MARIE (LMSW, ACSW, BCD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:SUMPTER
Suffix:
Gender:F
Credentials:LMSW, ACSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15700 PROVIDENCE DR.
Mailing Address - Street 2:1005
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075
Mailing Address - Country:US
Mailing Address - Phone:313-268-2073
Mailing Address - Fax:
Practice Address - Street 1:15700 PROVIDENCE DRIVE
Practice Address - Street 2:SUITE 1005
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:313-268-2073
Practice Address - Fax:313-748-7405
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2020-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010208121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical