What is Theodore Dziengelewski's NPI number?

The NPI number assigned to this healthcare provider is 1407593981, enumerated as a individual on May 17, 2022.

Where is the provider located?

The provider is located at 13101 ALLEN RD SOUTHGATE, MI 48195 and the phone number is (734) 785-7700.

What is the provider's specialty?

The provider's specialty is Peer Specialist with taxonomy code 175T00000X.

THEODORE JOSEPH DZIENGELEWSKI - NPI 1407593981 - Peer Specialist in Southgate, MI

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About Theodore Joseph Dziengelewski NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE JOSEPH DZIENGELEWSKI (NPI 1407593981) is an individual peer specialist in Southgate, Michigan and active in the NPI registry since May 2022.

NPPES Registry Identity

NPI1407593981

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameTHEODORE JOSEPH DZIENGELEWSKI

Location Address13101 ALLEN RDSouthgate, MI 48195-2216

Mailing Address13101 Allen RdSouthgate, MI 48195-2216 · (734) 785-7700

Phone(734) 785-7700

Sole ProprietorYes

Enumeration DateMay 17, 2022

NPPES CertifiedMay 17, 2022

✔ NPI 1407593981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

13101 ALLEN RD, Southgate, MI 48195

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP