Provider Demographics
NPI:1801995881
Name:HARTLEY, WILLIAM J (MSW LMSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:J
Last Name:HARTLEY
Suffix:
Gender:M
Credentials:MSW LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8623 N WAYNE ROAD
Mailing Address - Street 2:SUITE 323
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185
Mailing Address - Country:US
Mailing Address - Phone:734-742-0605
Mailing Address - Fax:734-742-0608
Practice Address - Street 1:8623 N WAYNE ROAD
Practice Address - Street 2:SUITE 323
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185
Practice Address - Country:US
Practice Address - Phone:734-742-0605
Practice Address - Fax:734-742-0608
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801074539104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker