Provider Demographics
NPI:1891390688
Name:TREE BY THE SEA COUNSELING, LLC
Entity Type:Organization
Organization Name:TREE BY THE SEA COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIETO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-265-0334
Mailing Address - Street 1:5068 N DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:MI
Mailing Address - Zip Code:48166-9691
Mailing Address - Country:US
Mailing Address - Phone:734-265-0334
Mailing Address - Fax:
Practice Address - Street 1:14989 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-3769
Practice Address - Country:US
Practice Address - Phone:734-265-0334
Practice Address - Fax:734-241-0014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty