Provider Demographics
NPI:1942589163
Name:HABER, JODIE (LMSW)
Entity type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:HABER
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 1:1951 CRAGIN DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFLD HLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2233
Mailing Address - Country:US
Mailing Address - Phone:941-685-7148
Mailing Address - Fax:
Practice Address - Street 1:1760 S TELEGRAPH RD STE 220
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0182
Practice Address - Country:US
Practice Address - Phone:941-685-7148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011061051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical