Healthcare Provider Details

I. General information

NPI: 1407710320
Provider Name (Legal Business Name): ELIZABETH TERREL MA, MFA, LPC, LLMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6963 W KL AVE
KALAMAZOO MI
49009-8043
US

IV. Provider business mailing address

228 N OAK PARK AVE APT 1M
OAK PARK IL
60302-2170
US

V. Phone/Fax

Practice location:
  • Phone: 269-459-9790
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451024248
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: