Provider Demographics
NPI:1770370298
Name:HENRY, STEVEN J (MSJ, CPSS, CHW)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:J
Last Name:HENRY
Suffix:
Gender:M
Credentials:MSJ, CPSS, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19182 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-3226
Mailing Address - Country:US
Mailing Address - Phone:734-686-7800
Mailing Address - Fax:
Practice Address - Street 1:19182 OHIO ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-3226
Practice Address - Country:US
Practice Address - Phone:734-686-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No374J00000XNursing Service Related ProvidersDoula