Provider Demographics
NPI:1881167559
Name:GURLEY, SANDRA (LMSW)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:GURLEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:JEAN
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:29430 WOODHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5278
Mailing Address - Country:US
Mailing Address - Phone:248-350-0456
Mailing Address - Fax:
Practice Address - Street 1:29430 WOODHAVEN LN
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5278
Practice Address - Country:US
Practice Address - Phone:248-350-0456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-06
Last Update Date:2019-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010667891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical