Provider Demographics
NPI:1871638494
Name:ULRICH, JAN CHRISTINE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JAN
Middle Name:CHRISTINE
Last Name:ULRICH
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 1:400 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3304
Mailing Address - Country:US
Mailing Address - Phone:734-709-4160
Mailing Address - Fax:
Practice Address - Street 1:400 N 1ST ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-3304
Practice Address - Country:US
Practice Address - Phone:734-709-4160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010689871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical