Provider Demographics
NPI:1124232491
Name:TSANGARIDES, ELAINE S (LPC, LLP)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:S
Last Name:TSANGARIDES
Suffix:
Gender:F
Credentials:LPC, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 ROYAL CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-4055
Mailing Address - Country:US
Mailing Address - Phone:248-650-8793
Mailing Address - Fax:
Practice Address - Street 1:4011 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-5558
Practice Address - Country:US
Practice Address - Phone:810-235-2500
Practice Address - Fax:810-234-6635
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401000399101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI520577OtherVALUE OPTIONS