Provider Demographics
NPI:1912267444
Name:MCIVER, DENNIELLE (MS LPC)
Entity Type:Individual
Prefix:
First Name:DENNIELLE
Middle Name:
Last Name:MCIVER
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36400 WOODWARD AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-0914
Mailing Address - Country:US
Mailing Address - Phone:248-973-7958
Mailing Address - Fax:
Practice Address - Street 1:36400 WOODWARD AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-0911
Practice Address - Country:US
Practice Address - Phone:248-878-5060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013249101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health