Provider Demographics
NPI:1063175420
Name:MANN, CARLOTTA TRENICE (LLMSW)
Entity type:Individual
Prefix:MRS
First Name:CARLOTTA
Middle Name:TRENICE
Last Name:MANN
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14820 ROSEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48223-2341
Mailing Address - Country:US
Mailing Address - Phone:313-712-8532
Mailing Address - Fax:
Practice Address - Street 1:18244 W MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-4163
Practice Address - Country:US
Practice Address - Phone:313-208-3407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical