Provider Demographics
NPI:1093562795
Name:BEUPLIFTED
Entity type:Organization
Organization Name:BEUPLIFTED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROOK
Authorized Official - Suffix:
Authorized Official - Credentials:LLMFT
Authorized Official - Phone:313-263-7245
Mailing Address - Street 1:15001 KERCHEVAL AVE
Mailing Address - Street 2:PMB 527
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1361
Mailing Address - Country:US
Mailing Address - Phone:313-263-7245
Mailing Address - Fax:
Practice Address - Street 1:15001 KERCHEVAL AVE
Practice Address - Street 2:PMB 527
Practice Address - City:GROSSE POINTE PARK
Practice Address - State:MI
Practice Address - Zip Code:48230-1361
Practice Address - Country:US
Practice Address - Phone:313-263-7245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty