Provider Demographics
NPI:1568033181
Name:TRIPI, JESSICA (LMSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:TRIPI
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 1:24901 NORTHWESTERN HWY STE 500
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2212
Mailing Address - Country:US
Mailing Address - Phone:248-258-0440
Mailing Address - Fax:
Practice Address - Street 1:24901 NORTHWESTERN HWY STE 500
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2212
Practice Address - Country:US
Practice Address - Phone:248-258-0440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011186361041C0700X
MI6851110138104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical