Provider Demographics
NPI:1528757366
Name:BEHRE, ELIZABETH KRISTINA (LLMSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KRISTINA
Last Name:BEHRE
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W WESTERN AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49440-1083
Mailing Address - Country:US
Mailing Address - Phone:269-455-9520
Mailing Address - Fax:
Practice Address - Street 1:1611 OAK AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-2468
Practice Address - Country:US
Practice Address - Phone:231-767-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511159851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical