Individual
SATABDI BANERJEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC, TLLP
Contact information
Practice address
1010 E WEST MAPLE RD, WALLED LAKE, MI 48390-3571
(248) 313-2900
Mailing address
30734 BEECHWOOD ST APT 47111, WIXOM, MI 48393-2804
(908) 630-7411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
6401016552
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38-1402860
—
MI
Enumeration date
04/18/2018
Last updated
05/01/2018
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