Provider Demographics
NPI:1831512912
Name:PULLEY, MARIA S I (LMSW)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:S
Last Name:PULLEY
Suffix:I
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16258 HILLSBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-2981
Mailing Address - Country:US
Mailing Address - Phone:734-512-8141
Mailing Address - Fax:
Practice Address - Street 1:16258 HILLSBRIAR DR
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-2981
Practice Address - Country:US
Practice Address - Phone:734-512-8141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801109824104100000X
MI6802087928104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIR300585067384Medicaid