Provider Demographics
NPI:1487683322
Name:HORWITZ, MICHAEL ROGER (MSW ACSW BCD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ROGER
Last Name:HORWITZ
Suffix:
Gender:M
Credentials:MSW ACSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25869 KELLY RD
Mailing Address - Street 2:STE A
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4997
Mailing Address - Country:US
Mailing Address - Phone:586-792-4008
Mailing Address - Fax:586-792-4063
Practice Address - Street 1:35782 HARPER AVENUE
Practice Address - Street 2:
Practice Address - City:CLLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035
Practice Address - Country:US
Practice Address - Phone:586-792-4008
Practice Address - Fax:586-792-4063
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010616541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical