Healthcare Provider Details

I. General information

NPI: 1528757366
Provider Name (Legal Business Name): ELIZABETH KRISTINA BEHRE LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 OAK AVE
MUSKEGON MI
49442-2468
US

IV. Provider business mailing address

1836 BUNDT DR
NORTON SHORES MI
49441-3402
US

V. Phone/Fax

Practice location:
  • Phone: 231-767-1921
  • Fax:
Mailing address:
  • Phone: 269-455-9520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801120196
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: