Provider Demographics
NPI:1376867887
Name:DEAN, ECHO IRENE (LMSW, RPT)
Entity Type:Individual
Prefix:MRS
First Name:ECHO
Middle Name:IRENE
Last Name:DEAN
Suffix:
Gender:F
Credentials:LMSW, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 S AIRPORT RD W
Mailing Address - Street 2:SUITE 7B
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7928
Mailing Address - Country:US
Mailing Address - Phone:231-715-8466
Mailing Address - Fax:231-946-8975
Practice Address - Street 1:3335 S AIRPORT RD W
Practice Address - Street 2:SUITE 7B
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7928
Practice Address - Country:US
Practice Address - Phone:231-715-8466
Practice Address - Fax:231-946-8975
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010859231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical