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General NPI Number Information
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NPI Number | 1326383639
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Entity Type | Individual
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Provider Name | ELIZABETH CLAYTON WHEELER
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Gender | Female
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 1050 SILVER DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-5749
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Country | US
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Telephone | 231-947-2255
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Fax | 231-947-5982
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Provider Business Mailing Address
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Address Line | 1105 SIXTH ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-2345
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Country | US
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Telephone | 231-935-3263
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 3223
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P006697
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851100683
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | MI
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