Provider Demographics
NPI:1396932000
Name:RICHARDS, JANET (MSW)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 ARDMORE AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-1753
Mailing Address - Country:US
Mailing Address - Phone:517-349-3600
Mailing Address - Fax:517-349-3663
Practice Address - Street 1:4700 ARDMORE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1753
Practice Address - Country:US
Practice Address - Phone:517-349-3600
Practice Address - Fax:517-349-3663
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010785321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical