Provider Demographics
NPI:1154505469
Name:ELLIOTT-REMES, RAELYN (LMSW, CAADC)
Entity Type:Individual
Prefix:
First Name:RAELYN
Middle Name:
Last Name:ELLIOTT-REMES
Suffix:
Gender:F
Credentials:LMSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 E GRAND RIVER AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-4958
Mailing Address - Country:US
Mailing Address - Phone:517-295-3726
Mailing Address - Fax:844-927-4501
Practice Address - Street 1:1750 E GRAND RIVER AVE STE 100
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-4958
Practice Address - Country:US
Practice Address - Phone:517-295-3726
Practice Address - Fax:844-927-4501
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801089486104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No104100000XBehavioral Health & Social Service ProvidersSocial Worker