MISS ELISE ASHLEY GOULBOURNE


Address: 5555 Conner St, Suite 1038, Detroit, MI 48213-3448
Phone: 3133080255

MISS ELISE ASHLEY GOULBOURNE (NPI# 1376966572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376966572
Entity Type Individual
Full Name MISS ELISE ASHLEY GOULBOURNE
Credential M.A., T.L.L.P.
Practice Address 5555 Conner St
Suite 1038
Detroit
MI 48213-3448
Practice Telephone 3133080255
Practice Fax Number 3133080270
Mailing Telephone 3133080255
Mailing Fax Number 3133080270
Enumeration Date 2014-01-24
Last Update Date 2014-04-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC1900X Psychologist
Specialization: Counseling
6301015813 MI Behavioral Health & Social Service Providers

Office Location

Street Address 5555 CONNER ST
SUITE 1038
City DETROIT
State MI
Zip Code 48213-3448

Providers in the same location

NPI Name Taxonomy Address Enumeration
1245237551 Mary L Serowoky Nurse Practitioner 5555 Conner St, St 2691, Detroit, MI 48213-3448 2005-06-30
1902422751 Dhaara Antani Dietitian, Registered 5555 Conner St, Detroit, MI 48213-3448 2020-06-17
1164066643 Bethany J. Howard Case Manager/Care Coordinator 5555 Conner St, Detroit, MI 48213-3448 2019-10-29
1699234153 Madison Community Hospital Inc Nurse Practitioner 5555 Conner St, Detroit, MI 48213-3448 2019-03-14
1700357563 Ashley Henninger Speech-Language Pathologist 5555 Conner St, Detroit, MI 48213-3448 2018-12-05
1720564651 Metropolitan Detroit Center for Independent Living Case Management 5555 Conner St, Detroit, MI 48213-3448 2018-07-13
1386158962 Sharon Diane Fowler Counselor 5555 Conner St, Detroit, MI 48213-3448 2017-11-19
1346605847 Shannon Crumbley In Home Supportive Care 5555 Conner St, 2079c, Detroit, MI 48213-3448 2015-12-28
1083080121 Sonya Shelman Social Worker 5555 Conner St, Detroit, MI 48213-3448 2015-08-12
1629450960 Marquetta Turner Social Worker 5555 Conner St, Suite 1038, Detroit, MI 48213-3448 2015-06-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215540430 Sheronda Lanetta Blackmon Licensed Practical Nurse 13929 Harper Ave., Detroit, MI 48213 2020-08-27
1073049144 Cheryl Williams Community Health Worker 13929 Chalmers Ave., Detroit, MI 48213 2017-05-10
1164963401 Smile Fresh Detroit PC Dentist 7230 Gratiot Avenue, Detroit, MI 48213 2017-03-20
1255887899 Jay Washington Behavioral Analyst 9146 Haper, Detroit, MI 48213 2016-09-01
1396129532 Sarietha King Home Health 14639 Manistique, Detroit, MI 48213 2015-07-17
1366823197 Royal Treatment Mental Health Systems, LLC Counselor 5555 Corner Avenue, Detroit, MI 48213 2015-06-17
1477956779 Monique Powell Student in an Organized Health Care Education/Training Program 5801 Lakeview S.t, Detroit, MI 48213 2014-09-30
1629339163 Samuel Joseph Farmer Counselor 10100 Harper Ave., Detroit, MI 48213 2012-05-31
1609164755 Vernon Keith Johnson Social Worker 20203 Kelly Road, Detroit, MI 48213 2011-07-11
1023312790 Davenport Quality Home Care LLC Home Health 5027 Maxwell, Detroit, MI 48213 2011-01-10
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Taxonomy Information

Taxonomy Code 103TC1900X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Counseling

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1386114163 Katrina Lynn Griffin Psychologist 15017 Liberal St, Detroit, MI 48205-1967 2018-12-05
1063865830 Gloria A. Love Psychologist 19677 Revere, Detroit, MI 48234 2016-07-18
1710316534 How-adolescent Substance Abuse Program, LLC Psychologist 8131 E Outer Dr, Detroit, MI 48213-1323 2013-11-02
1609213354 Patrick Jumbo Eyo Psychologist 7810 Southfield Fwy, Detroit, MI 48228-3580 2013-06-03
1255595948 Crystal A. Jackson Psychologist 3011 W Grand Blvd Ste 413, Detroit, MI 48202-3011 2008-07-11
1235301656 Regina Brown Psychologist 14540 Faust Ave, Detroit, MI 48223-2321 2008-03-26
1679055982 Erica Jaske Psychologist 40 E Ferry St, Detroit, MI 48202-3802 2018-09-04
1710308598 Alissa Dugan Psychologist 1700 Waterman St, Detroit, MI 48209-2022 2013-12-23
1548606320 Sherry Ellen Mcrill Psychologist 2900 Conner St, Bldg A, Detroit, MI 48215-2407 2013-05-20
1609128503 Joann Thompson Psychologist 2925 Russell St, Detroit, MI 48207-4825 2012-10-03
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Competitor

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City DETROIT
Zip Code 48213

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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