Healthcare Provider Details

I. General information

NPI: 1629977897
Provider Name (Legal Business Name): PIPER R ELLIOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2026
Last Update Date: 11/04/2026
Certification Date: 11/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 E CESAR E CHAVEZ AVE UNIT 1
LANSING MI
48906-5343
US

IV. Provider business mailing address

823 E CESAR E CHAVEZ AVE UNIT 1
LANSING MI
48906-5343
US

V. Phone/Fax

Practice location:
  • Phone: 517-881-1756
  • Fax:
Mailing address:
  • Phone: 517-881-1756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851122947
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: