Provider Demographics
NPI:1457570137
Name:BUFORD, CLAUDENIA RENEE (MSW,CSW)
Entity Type:Individual
Prefix:MS
First Name:CLAUDENIA
Middle Name:RENEE
Last Name:BUFORD
Suffix:
Gender:F
Credentials:MSW,CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20549 CHARLTON SQ APT 107
Mailing Address - Street 2:#107
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20549 CHARLTON SQ APT 107
Practice Address - Street 2:#107
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-4007
Practice Address - Country:US
Practice Address - Phone:248-355-1452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010696401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI143412OtherPROVIDER ID
MI8008955480OtherPROVIDER ID
MI8008955480OtherPROVIDER ID