Provider Demographics
NPI:1265205868
Name:CENTER FOR EMOTIONAL WELLBEING
Entity type:Organization
Organization Name:CENTER FOR EMOTIONAL WELLBEING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MILNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-921-3344
Mailing Address - Street 1:3719 HI DALE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360-2422
Mailing Address - Country:US
Mailing Address - Phone:248-921-3344
Mailing Address - Fax:
Practice Address - Street 1:805 OAKWOOD DR STE 114
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-6206
Practice Address - Country:US
Practice Address - Phone:248-921-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1437640018OtherNPI 1
MI6801091515OtherSOCIAL WORK LICENSE