Provider Demographics
NPI:1376306209
Name:LUIDENS, ELIZABETH (LLMSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LUIDENS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:LYZ
Other - Middle Name:
Other - Last Name:LUIDENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3697 LAKEPOINTE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-3357
Mailing Address - Country:US
Mailing Address - Phone:616-550-3099
Mailing Address - Fax:
Practice Address - Street 1:21611 E 11 MILE RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1636
Practice Address - Country:US
Practice Address - Phone:586-944-2902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511177361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical