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NPI Code Detail

MEDICARE: KELSEY EBERHARD LLMSW

MEDICARE: KELSEY EBERHARD LLMSW
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
1104100000XSocial Worker6801104956MI

General Provider Information

NPI Number : 1275174062
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY EBERHARD LLMSW
Provider Business Mailing Address
First Line : 1255 N OAKLAND BLVD
Second Line :
City : WATERFORD
State : MI
Zip : 48327-1545
Country : US
Telephone Number : 248-599-8999
Fax Number :
Provider Business Practice Location Address
First Line : 1255 N OAKLAND BLVD
Second Line :
City : WATERFORD
State : MI
Zip : 48327-1545
Country : US
Telephone Number : 248-599-8999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2019
Last Update Date : 04/12/2026

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Directions to “ KELSEY EBERHARD LLMSW” Practice Location

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