Provider Demographics
NPI:1306458963
Name:ERICA MCNEELY, LLC
Entity type:Organization
Organization Name:ERICA MCNEELY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LMSW/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLIDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-250-2842
Mailing Address - Street 1:675 W DAWSON RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-2718
Mailing Address - Country:US
Mailing Address - Phone:248-250-2842
Mailing Address - Fax:
Practice Address - Street 1:675 W DAWSON RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-2718
Practice Address - Country:US
Practice Address - Phone:248-250-2842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty