Provider Demographics
NPI:1033586474
Name:TERRELL-PEOPLES, LELA Y
Entity Type:Individual
Prefix:
First Name:LELA
Middle Name:Y
Last Name:TERRELL-PEOPLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LELA
Other - Middle Name:Y
Other - Last Name:TERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16877 CARLISLE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48205-1505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:302 S MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2657
Practice Address - Country:US
Practice Address - Phone:947-217-2743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801117451104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker