Provider Demographics
NPI:1285907543
Name:VETRANO, JOHN DANIEL (LMSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DANIEL
Last Name:VETRANO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1781 MOORHOUSE ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1193
Mailing Address - Country:US
Mailing Address - Phone:248-677-3056
Mailing Address - Fax:
Practice Address - Street 1:1781 MOORHOUSE ST
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1193
Practice Address - Country:US
Practice Address - Phone:248-677-3056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010130931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical