Provider Demographics
NPI:1629860069
Name:CHMIELEWSKI, JEFF (LLPC, ATR-P)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:CHMIELEWSKI
Suffix:
Gender:M
Credentials:LLPC, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5468 LAWNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-9085
Mailing Address - Country:US
Mailing Address - Phone:810-599-1891
Mailing Address - Fax:
Practice Address - Street 1:29887 W 11 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1309
Practice Address - Country:US
Practice Address - Phone:248-476-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI24-685221700000X
MI6451023934101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist