Provider Demographics
NPI:1154153997
Name:PIELLUSCH, EMILY K (LLMSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:PIELLUSCH
Suffix:
Gender:X
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 N ADAMS ST APT 5
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-2563
Mailing Address - Country:US
Mailing Address - Phone:231-350-6234
Mailing Address - Fax:
Practice Address - Street 1:310 N ADAMS ST APT 5
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-2563
Practice Address - Country:US
Practice Address - Phone:231-350-6234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511187071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical