MEDICARE: MRS. ELIZABETH ANN HUSBANDS MA LLP

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	103TC1900X	Counseling Psychologist	6361005039	MI
2	247200000X	Other Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6301010597	OTHER	MI	PSYCHOLOGY LICENSE

General Provider Information

NPI Number	:	1518410992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH ANN HUSBANDS MA LLP

Provider Business Mailing Address
First Line	:	1604 E HIGH ST
Second Line	:
City	:	MOUNT PLEASANT
State	:	MI
Zip	:	48858-8928
Country	:	US
Telephone Number	:	989-621-6432
Fax Number	:

Provider Business Practice Location Address
First Line	:	1604 E HIGH ST
Second Line	:
City	:	MOUNT PLEASANT
State	:	MI
Zip	:	48858-8928
Country	:	US
Telephone Number	:	989-621-6432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2016
Last Update Date	:	09/15/2025

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