Provider Demographics
NPI:1205662053
Name:BIRCKBICHLER, DANIEL (LLMSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BIRCKBICHLER
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4017 CHESTER DR APT 112
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-7240
Mailing Address - Country:US
Mailing Address - Phone:413-270-0881
Mailing Address - Fax:
Practice Address - Street 1:2755 CARPENTER RD STE 3SE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1187
Practice Address - Country:US
Practice Address - Phone:734-548-6099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511188571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical