Individual
MR. CHARLES SONNY PHIPPS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
882 OAKMAN BLVD, DETROIT, MI 48238-3710
(313) 961-7990
(313) 961-5120
Mailing address
16204 MOUNT VERNON ST, SOUTHFIELD, MI 48075-3108
(313) 920-1011
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
6801094562
MI
Other
Enumeration date
02/21/2009
Last updated
09/08/2016
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