Provider Demographics
NPI:1720481583
Name:KATTAN, SUAD (BSWLBSW)
Entity Type:Individual
Prefix:
First Name:SUAD
Middle Name:
Last Name:KATTAN
Suffix:
Gender:F
Credentials:BSWLBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20825 CASS
Mailing Address - Street 2:
Mailing Address - City:FAMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335
Mailing Address - Country:US
Mailing Address - Phone:248-797-0322
Mailing Address - Fax:248-476-0309
Practice Address - Street 1:100 RIVER PLACE DR STE 250
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-5402
Practice Address - Country:US
Practice Address - Phone:313-871-2337
Practice Address - Fax:313-871-6655
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68020815521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical