Healthcare Provider Details

I. General information

NPI: 1982783445
Provider Name (Legal Business Name): ASHITA GHELANI MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 01/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3960 PATIENT CARE WAY SUITE 104
LANSING MI
48911-4275
US

IV. Provider business mailing address

3960 PATIENT CARE WAY SUITE 104
LANSING MI
48911-4275
US

V. Phone/Fax

Practice location:
  • Phone: 517-887-9801
  • Fax: 517-887-9826
Mailing address:
  • Phone: 517-887-9801
  • Fax: 517-887-9826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6301012525
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801087527
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: