Provider Demographics
NPI:1407448731
Name:ELYSIAN COUNSELING & EDUCATION LLC
Entity Type:Organization
Organization Name:ELYSIAN COUNSELING & EDUCATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PRINCIPAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DWAN
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:MILAM-REED
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW-S
Authorized Official - Phone:832-928-5173
Mailing Address - Street 1:20214 TIMBERSTONE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8897
Mailing Address - Country:US
Mailing Address - Phone:832-928-5173
Mailing Address - Fax:832-203-1727
Practice Address - Street 1:20214 TIMBERSTONE LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-8897
Practice Address - Country:US
Practice Address - Phone:832-928-5173
Practice Address - Fax:832-203-1727
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELYSIAN COUNSELING & EDUCATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty