Healthcare Provider Details

I. General information

NPI: 1225623812
Provider Name (Legal Business Name): ELIZABETH TEKLINSKI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2021
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 EAGLES NEST RD
INDIAN RIVER MI
49749-9749
US

IV. Provider business mailing address

819 W SEVENTH ST UNIT A
TRAVERSE CITY MI
49684-2438
US

V. Phone/Fax

Practice location:
  • Phone: 231-622-1928
  • Fax:
Mailing address:
  • Phone: 231-210-2976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH M TEKINSKI
Title or Position: MEMBER
Credential: PH.D., LPC
Phone: 231-622-1928