Provider Demographics
NPI:1245699008
Name:ADDO, AKUA AKOMAA (LLMSW)
Entity type:Individual
Prefix:MS
First Name:AKUA
Middle Name:AKOMAA
Last Name:ADDO
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5752 ALDINGBROOKE CIRCLE RD S
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1309
Mailing Address - Country:US
Mailing Address - Phone:313-415-2997
Mailing Address - Fax:
Practice Address - Street 1:6075 SILVERBROOK W
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-1014
Practice Address - Country:US
Practice Address - Phone:313-415-2997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801099048104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801099048OtherMSW LICENSE