Provider Demographics
NPI:1972326254
Name:DEAN, CALLIE (LLMSW)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:DEAN
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 1:271 S HURON RD
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:48634-9482
Mailing Address - Country:US
Mailing Address - Phone:989-450-8019
Mailing Address - Fax:
Practice Address - Street 1:70 N FROST DR STE 2
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-5796
Practice Address - Country:US
Practice Address - Phone:989-372-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851118934104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker