Basic Information
| Provider Information | |||||||||
| NPI: | 1235362070 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRONG | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 79 W ALEXANDRINE ST | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482012015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3138312608 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11111 HALL RD STE 303 | ||||||||
| Address2: | |||||||||
| City: | UTICA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5869973153 | ||||||||
| FaxNumber: | 5869974956 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2009 | ||||||||
| LastUpdateDate: | 07/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801091353 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.