Provider Demographics
NPI:1205980133
Name:SENAWI, JANAN NAIM (LCSW)
Entity type:Individual
Prefix:MR
First Name:JANAN
Middle Name:NAIM
Last Name:SENAWI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4868 QUARTON RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2546
Mailing Address - Country:US
Mailing Address - Phone:248-354-8460
Mailing Address - Fax:248-354-4979
Practice Address - Street 1:20300 CIVIC CENTER DR
Practice Address - Street 2:SUITE 318
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-4105
Practice Address - Country:US
Practice Address - Phone:248-354-8460
Practice Address - Fax:248-354-4979
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801069090101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3434247Medicaid