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NPI Code Detail

MEDICARE: MRS. HEATHER LEIGH ELLIS LBSW

MEDICARE: MRS. HEATHER LEIGH ELLIS LBSW
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
1171M00000XCase Manager/Care Coordinator6802084108MI

General Provider Information

NPI Number : 1386797892
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HEATHER LEIGH ELLIS LBSW
Provider Business Mailing Address
First Line : 500 HANCOCK
Second Line : SAGINAW COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
City : SAGINAW
State : MI
Zip : 48602
Country : US
Telephone Number : 989-797-3400
Fax Number : 989-797-3522
Provider Business Practice Location Address
First Line : 3665 BAY RD
Second Line :
City : SAGINAW
State : MI
Zip : 48603-2445
Country : US
Telephone Number : 989-799-6542
Fax Number : 989-799-6681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 01/27/2020

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Directions to “ MRS. HEATHER LEIGH ELLIS LBSW” Practice Location

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