Provider Demographics
NPI:1992989784
Name:STEPHENS, URIEL AURORA (LMSW)
Entity type:Individual
Prefix:
First Name:URIEL
Middle Name:AURORA
Last Name:STEPHENS
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 1:4321 E MCNICHOLS RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48212-1720
Mailing Address - Country:US
Mailing Address - Phone:313-369-1717
Mailing Address - Fax:313-369-1717
Practice Address - Street 1:17141 RYAN RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48212-1112
Practice Address - Country:US
Practice Address - Phone:313-369-1717
Practice Address - Fax:313-369-1717
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010898491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical