MEDICARE: EUNOIA THERAPY COLLECTIVE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1588538748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUNOIA THERAPY COLLECTIVE PLLC

Provider Business Mailing Address
First Line	:	721 WASHINGTON AVE STE 307
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-5724
Country	:	US
Telephone Number	:	989-482-4008
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 WASHINGTON AVE STE 307
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-5724
Country	:	US
Telephone Number	:	989-482-4008
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	KATIE SUZANNE ESTELLE
Credential	:	LMSW
Telephone Number	:	989-482-4008

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	10/01/2025

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