Provider Demographics
NPI:1972864973
Name:ELIZABETH GUEST LMSW,LLC
Entity Type:Organization
Organization Name:ELIZABETH GUEST LMSW,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GUEST
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-777-7503
Mailing Address - Street 1:19900 SAVAGE RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-9676
Mailing Address - Country:US
Mailing Address - Phone:734-777-7503
Mailing Address - Fax:
Practice Address - Street 1:7000 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2583
Practice Address - Country:US
Practice Address - Phone:734-777-7503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801089752251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health