Provider Demographics
NPI:1407634777
Name:MARKOWITZ, MARCI ANNE
Entity type:Individual
Prefix:
First Name:MARCI
Middle Name:ANNE
Last Name:MARKOWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 HERON VIEW CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-3997
Mailing Address - Country:US
Mailing Address - Phone:248-425-1624
Mailing Address - Fax:
Practice Address - Street 1:5745 W MAPLE RD STE 213
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4488
Practice Address - Country:US
Practice Address - Phone:248-862-5110
Practice Address - Fax:844-893-1355
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010461821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical