Provider Demographics
NPI:1962634618
Name:MICHIGAN EMPLOYEE ASSISTANCE CONSULTANT PLLC
Entity Type:Organization
Organization Name:MICHIGAN EMPLOYEE ASSISTANCE CONSULTANT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/EAP
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWNA
Authorized Official - Middle Name:CAROLA
Authorized Official - Last Name:WESTBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMSW,CAC
Authorized Official - Phone:810-252-1186
Mailing Address - Street 1:G3500 FLUSHING RD STE 108
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-4247
Mailing Address - Country:US
Mailing Address - Phone:810-424-0640
Mailing Address - Fax:810-424-0387
Practice Address - Street 1:G3500 FLUSHING RD STE 108
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-4247
Practice Address - Country:US
Practice Address - Phone:810-252-1186
Practice Address - Fax:810-424-0387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801058036261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0897750OtherBCBSM
MI11586744OtherCAQH
MI0897750OtherBCBSM