Provider Demographics
NPI:1295043818
Name:TALBOT, ELIZABETH GRAZIOLI (LPC, LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:GRAZIOLI
Last Name:TALBOT
Suffix:
Gender:F
Credentials:LPC, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 W. BIG BEAVER RD.
Mailing Address - Street 2:1450
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084
Mailing Address - Country:US
Mailing Address - Phone:248-244-8644
Mailing Address - Fax:248-244-1330
Practice Address - Street 1:888 W BIG BEAVER RD
Practice Address - Street 2:1450
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4736
Practice Address - Country:US
Practice Address - Phone:248-244-8644
Practice Address - Fax:248-244-1330
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1778658101YM0800X
MIL1356631101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional