Provider Demographics
NPI:1336249069
Name:HOLEFCA, DANIEL STEPHEN JR (LMSW CSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:STEPHEN
Last Name:HOLEFCA
Suffix:JR
Gender:M
Credentials:LMSW CSW
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Mailing Address - Street 1:36975 UTICA ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036
Mailing Address - Country:US
Mailing Address - Phone:586-226-3440
Mailing Address - Fax:586-226-3672
Practice Address - Street 1:45445 MOUND
Practice Address - Street 2:SUITE 109
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317
Practice Address - Country:US
Practice Address - Phone:586-254-5660
Practice Address - Fax:586-254-0622
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MI68010080921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM10270024Medicare ID - Type Unspecified