Provider Demographics
NPI:1124532544
Name:GLOBE, EVELYN L (LLPC)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:L
Last Name:GLOBE
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 38836
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48238-0836
Mailing Address - Country:US
Mailing Address - Phone:313-247-3152
Mailing Address - Fax:
Practice Address - Street 1:32231 SCHOOLCRAFT RD STE 210
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-4322
Practice Address - Country:US
Practice Address - Phone:734-266-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106401015517101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional