Provider Demographics
NPI:1689381055
Name:BAIOCCHI, ELANA MAIRE (LLPC)
Entity Type:Individual
Prefix:PROF
First Name:ELANA
Middle Name:MAIRE
Last Name:BAIOCCHI
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1584 W KIRBY RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-9059
Mailing Address - Country:US
Mailing Address - Phone:126-983-2977
Mailing Address - Fax:
Practice Address - Street 1:2775 W DICKMAN RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MI
Practice Address - Zip Code:49037-4895
Practice Address - Country:US
Practice Address - Phone:269-883-6560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MI6451022426101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health