Basic Information
| Provider Information | |||||||||
| NPI: | 1295137990 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CURTIS | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | LPC, CAADC, NCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28736 5 MILE RD | ||||||||
| Address2: | |||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481543812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342236705 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6548 TOWN CENTER DR STE D | ||||||||
| Address2: | |||||||||
| City: | CLARKSTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483464823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8006931916 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2014 | ||||||||
| LastUpdateDate: | 08/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 6401017122 | MI | N | Behavioral Health & Social Service Providers | Counselor | 101YP2500X | 6401019202 | MI | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101Y00000X | 6401019202 | MI | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.