Provider Demographics
NPI:1538204888
Name:MARKIEWICZ, ANNE RUTH (MSW,LICSW,CDP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:RUTH
Last Name:MARKIEWICZ
Suffix:
Gender:F
Credentials:MSW,LICSW,CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 W WASHINGTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-1236
Mailing Address - Country:US
Mailing Address - Phone:517-205-4001
Mailing Address - Fax:517-205-0126
Practice Address - Street 1:2424 W WASHINGTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-1236
Practice Address - Country:US
Practice Address - Phone:517-205-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010699791041C0700X
WACP00004940101YA0400X
WALW000080391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)