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General NPI Number Information
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NPI Number | 1710430277
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Entity Type | Individual
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Provider Name | NEESHAN MEHRETU-HARMENIL LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 4572 S HAGADORN RD STE 3C
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City | EAST LANSING
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State | MI
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Zip | 48823-5385
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Country | US
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Telephone | 517-896-2766
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | MASON
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State | MI
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Zip | 48854-0010
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | MI
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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 | 6801100155
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License Number State | MI
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