Provider Demographics
NPI:1225020985
Name:CASS, JAMES N JR (MSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:N
Last Name:CASS
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:N
Other - Last Name:CASS
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:DCSW, BCD
Mailing Address - Street 1:28175 HAGGERTY RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2903
Mailing Address - Country:US
Mailing Address - Phone:313-205-8860
Mailing Address - Fax:248-354-8336
Practice Address - Street 1:28175 HAGGERTY RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2903
Practice Address - Country:US
Practice Address - Phone:248-994-7668
Practice Address - Fax:248-994-7652
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010580411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OP12940Medicare ID - Type Unspecified