Tabak, Ellen Rose
Tabak, Ellen Rose is an individual health care provider with primary practice located at 101 W Long Lake Rd , Bloomfield Hills MI 48304-2749. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Tabak, Ellen Rose can be contacted via phone (248) 480-4965.Contact Information
Primary practice address
101 W Long Lake Rd
Bloomfield Hills MI 48304-2749
Phone: (248) 480-4965
Fax: (248) 480-4966
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 6801018478 | Michigan |
Profile Details
| NPI number | 1396743704 |
|---|---|
| LBN Legal business name | Tabak, Ellen Rose |
| Credentials | ACSW, M.A. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 9th, 2005 |
| Last updated | Oct 7th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396743704 | NPPES |
| Michigan | Other | 382778765 | CIGNA / VENDOR # 1139981 |
| Michigan | Other | 750910718 | CIGNA / VENDOR # 1139981 |
| Michigan | Other | 247423000 | CIGNA / VENDOR # 1139981 |
| Michigan | Other | 51940-01 | CIGNA / VENDOR # 1139981 |
| Michigan | Other | 9359445 | CIGNA / VENDOR # 1139981 |
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