Dougherty, Eleanor Louise

Dougherty, Eleanor Louise is an sole proprietor health care provider with primary practice located at 1341 N 26Th St Penstar Office Center Ste 103, Escanaba MI 49829-2515. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Dougherty, Eleanor Louise can be contacted via phone (906) 233-9588.

Contact Information

Primary practice address
1341 N 26Th St Penstar Office Center Ste 103 Escanaba MI 49829-2515
Phone: (906) 233-9588
Fax: (906) 217-2008
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 6801069892 Michigan
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 3446- 123 Wisconsin
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 6801069892 Michigan
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 3446- 123 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 6801069892 Michigan
Behavioral Health & Social Service Providers / Professional 101YP2500X 3446- 123 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6801069892 Michigan
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3446-123 Wisconsin
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 6801069892 Michigan

Profile Details

NPI number 1295715498
LBN Legal business name Dougherty, Eleanor Louise
Credentials LMSW-C/M.DCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 23rd, 2006
Last updated Jan 7th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295715498 NPPES
Other 170082-000 MAGELLAN INDIVIDUAL ID
Other 0897996 MAGELLAN INDIVIDUAL ID
Other 8008979960 MAGELLAN INDIVIDUAL ID

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