Provider Demographics
NPI:1710679618
Name:EISENBERG MENTAL HEALTH AND COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:EISENBERG MENTAL HEALTH AND COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:EISENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-846-7443
Mailing Address - Street 1:1997 SEVERN RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1960
Mailing Address - Country:US
Mailing Address - Phone:734-846-7443
Mailing Address - Fax:
Practice Address - Street 1:1997 SEVERN RD
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-1960
Practice Address - Country:US
Practice Address - Phone:734-846-7443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty