Provider Demographics
NPI:1700243151
Name:EILERS, PATRICK G (LLPC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:G
Last Name:EILERS
Suffix:
Gender:M
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44070 W 12 MILE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2648
Mailing Address - Country:US
Mailing Address - Phone:248-773-8440
Mailing Address - Fax:
Practice Address - Street 1:44070 W 12 MILE RD STE 200
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2648
Practice Address - Country:US
Practice Address - Phone:248-773-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016564101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional