Healthcare Provider Details

I. General information

NPI: 1093115032
Provider Name (Legal Business Name): ELIZABETH SPOTTS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH FIRESTONE MSW, LLMSW

II. Dates (important events)

Enumeration Date: 08/27/2014
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BAILEY ST
EAST LANSING MI
48823-4688
US

IV. Provider business mailing address

350 N MAIN ST STE 220
CHELSEA MI
48118-1370
US

V. Phone/Fax

Practice location:
  • Phone: 517-273-2706
  • Fax:
Mailing address:
  • Phone: 734-433-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801094777
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: