Provider Demographics
NPI:1285884148
Name:ARVILLA, DENIS ERIN (MED, MSW, LPC)
Entity type:Individual
Prefix:
First Name:DENIS
Middle Name:ERIN
Last Name:ARVILLA
Suffix:
Gender:F
Credentials:MED, MSW, LPC
Other - Prefix:
Other - First Name:DENIS
Other - Middle Name:ERIN
Other - Last Name:ARVILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MSW, LPC
Mailing Address - Street 1:5767 MAIN STREET
Mailing Address - Street 2:LOT #17
Mailing Address - City:LEXINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48450
Mailing Address - Country:US
Mailing Address - Phone:810-359-2390
Mailing Address - Fax:
Practice Address - Street 1:1852 WEST GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48208
Practice Address - Country:US
Practice Address - Phone:313-894-8444
Practice Address - Fax:313-894-5542
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401001676101YP2500X
MI68010614871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0G46345Medicare PIN