Provider Demographics
NPI:1144837485
Name:ULLERY, NOEL (LMSW)
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:ULLERY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:NOEL
Other - Middle Name:
Other - Last Name:SPRING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6011 JOY RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48204-2909
Mailing Address - Country:US
Mailing Address - Phone:313-455-0129
Mailing Address - Fax:
Practice Address - Street 1:6011 JOY RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48204-2909
Practice Address - Country:US
Practice Address - Phone:313-455-0129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011070611041C0700X
MI68511070611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical