Healthcare Provider Details

I. General information

NPI: 1013840628
Provider Name (Legal Business Name): EFIZEW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2107 REO RD
LANSING MI
48910
US

IV. Provider business mailing address

2107 REO RD
LANSING MI
48910
US

V. Phone/Fax

Practice location:
  • Phone: 517-214-2986
  • Fax:
Mailing address:
  • Phone: 517-214-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: YODIT WOLDEGABREL
Title or Position: 0WNER
Credential: WOLDEGABREL
Phone: 517-214-2986