Individual
CHASE T BOUSCHOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
3200 GREENFIELD RD STE 300, DEARBORN, MI 48120-1805
(646) 453-6777
Mailing address
3200 GREENFIELD RD STE 300, DEARBORN, MI 48120-1805
(646) 453-6777
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
6801122172
MI
1041C0700X
Clinical Social Worker
Primary
6851114844
MI
Other
Enumeration date
05/04/2022
Last updated
05/17/2026
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