Provider Demographics
NPI:1881874659
Name:RUNEY, ALETA MARIE (LMSW, CCM, ACSW)
Entity type:Individual
Prefix:MS
First Name:ALETA
Middle Name:MARIE
Last Name:RUNEY
Suffix:
Gender:F
Credentials:LMSW, CCM, ACSW
Other - Prefix:
Other - First Name:ALETA
Other - Middle Name:MARIE
Other - Last Name:DEPETRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22343 KINYON ST
Mailing Address - Street 2:UNIT 12
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3692
Mailing Address - Country:US
Mailing Address - Phone:313-768-5574
Mailing Address - Fax:313-576-1074
Practice Address - Street 1:4646 JOHN R ST
Practice Address - Street 2:MENTAL HEALTH- HCHV
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-1916
Practice Address - Country:US
Practice Address - Phone:313-576-3611
Practice Address - Fax:313-576-1074
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801064768104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker