Healthcare Provider Details

I. General information

NPI: 1659919009
Provider Name (Legal Business Name): EMILY NOEL LAFAYETTE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2019
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 E OAKLEY PARK RD STE 203
COMMERCE TOWNSHIP MI
48390-4318
US

IV. Provider business mailing address

1766 CORA ST
WYANDOTTE MI
48192-7218
US

V. Phone/Fax

Practice location:
  • Phone: 248-671-7872
  • Fax:
Mailing address:
  • Phone: 734-778-8843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801120610
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: