Provider Demographics
NPI:1093420960
Name:EMHPE MICHIGAN PLLC
Entity Type:Organization
Organization Name:EMHPE MICHIGAN PLLC
Other - Org Name:ELLIE MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-427-2966
Mailing Address - Street 1:238 HOOVER BLVD STE 30
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3782
Mailing Address - Country:US
Mailing Address - Phone:616-312-2989
Mailing Address - Fax:
Practice Address - Street 1:238 HOOVER BLVD STE 30
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3782
Practice Address - Country:US
Practice Address - Phone:616-312-2989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-16
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty