Provider Demographics
NPI:1659919009
Name:LAFAYETTE, EMILY NOEL (LLMSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:NOEL
Last Name:LAFAYETTE
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 W SPRING ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1325
Mailing Address - Country:US
Mailing Address - Phone:734-778-8843
Mailing Address - Fax:
Practice Address - Street 1:261 W SPRING ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1325
Practice Address - Country:US
Practice Address - Phone:734-778-8843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511088771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical