Provider Demographics
NPI:1740731397
Name:SMILEY, ELEANOR (CPSS,RECOVERY COACH)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:SMILEY
Suffix:
Gender:F
Credentials:CPSS,RECOVERY COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 OAKMAN BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48238-3710
Mailing Address - Country:US
Mailing Address - Phone:313-967-5950
Mailing Address - Fax:313-883-6275
Practice Address - Street 1:882 OAKMAN BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238-3710
Practice Address - Country:US
Practice Address - Phone:313-967-5950
Practice Address - Fax:313-883-6275
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)