Provider Demographics
NPI:1225345101
Name:ROUSER, NAOMI GRACE (LMSW)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:GRACE
Last Name:ROUSER
Suffix:
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 1:236 SILMAN ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-2509
Mailing Address - Country:US
Mailing Address - Phone:482-885-4909
Mailing Address - Fax:
Practice Address - Street 1:236 SILMAN ST
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-2509
Practice Address - Country:US
Practice Address - Phone:248-885-4909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801091512104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker