Provider Demographics
NPI:1548323660
Name:NADOLSKI, JEROME NORBERT (LMSW LMFT CEAP)
Entity type:Individual
Prefix:MR
First Name:JEROME
Middle Name:NORBERT
Last Name:NADOLSKI
Suffix:
Gender:M
Credentials:LMSW LMFT CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15565 NORTHLAND DR
Mailing Address - Street 2:SUITE 505W
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075
Mailing Address - Country:US
Mailing Address - Phone:248-483-3100
Mailing Address - Fax:248-483-3104
Practice Address - Street 1:15565 NORTHLAND DR
Practice Address - Street 2:SUITE 505W
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-483-3100
Practice Address - Fax:248-483-3104
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL870334101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health