MEDICARE: TAPESTRY COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1033763610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAPESTRY COUNSELING LLC

Provider Business Mailing Address
First Line	:	854 W GRAND RIVER AVE
Second Line	:
City	:	BRIGHTON
State	:	MI
Zip	:	48116-2303
Country	:	US
Telephone Number	:	810-207-1556
Fax Number	:

Provider Business Practice Location Address
First Line	:	854 W GRAND RIVER AVE
Second Line	:
City	:	BRIGHTON
State	:	MI
Zip	:	48116-2303
Country	:	US
Telephone Number	:	810-207-1556
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER/OWNER
Name	:	ERIN ELIZABETH DUNAHOO
Credential	:	LMSW
Telephone Number	:	810-207-1556

Provider Enumeration Date	:	07/31/2019
Last Update Date	:	07/31/2019

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