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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC1900X |
Psychologist Specialization: Counseling |
6301015813 | MI | Behavioral Health & Social Service Providers |
Street Address |
5555 CONNER ST SUITE 1038 |
City | DETROIT |
State | MI |
Zip Code | 48213-3448 |
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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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 |
Find all providers in zip 48213 |
Taxonomy Code | 103TC1900X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Counseling |
Definition to come... |
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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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.