Organization Name: | ELEMENTS BEHAVIORAL HEALTH PLLC |
NPI Number: | 1376882290 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICOLE C DINGWELL (OWNER) |
Mailing Address: | 1651 Pratt Rd Dewitt |
State: | MI US |
Postal Code: | 48820 |
Phone Number: | 5176670061 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2013 |
NPI Last Update Date: | 02/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801092564 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |