Provider Demographics
NPI:1902904048
Name:HARDEN, JANET L (BSW)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:L
Last Name:HARDEN
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11274 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48205-3204
Mailing Address - Country:US
Mailing Address - Phone:313-372-9134
Mailing Address - Fax:
Practice Address - Street 1:4321 E MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48212-1720
Practice Address - Country:US
Practice Address - Phone:313-369-1717
Practice Address - Fax:313-369-1728
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802070568104100000X
MI6401006415101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN97450003Medicare ID - Type UnspecifiedMEDICARE