Basic Information
Provider Information
NPI: 1003151523
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGEE
FirstName: ELIZABETH
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: L.L.P.C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 70050 M 66
Address2:  
City: STURGIS
State: MI
PostalCode: 490919431
CountryCode: US
TelephoneNumber: 2696511212
FaxNumber: 2696598472
Practice Location
Address1: 70050 M 66
Address2:  
City: STURGIS
State: MI
PostalCode: 490919431
CountryCode: US
TelephoneNumber: 2696511212
FaxNumber: 2696598472
Other Information
ProviderEnumerationDate: 12/10/2012
LastUpdateDate: 12/10/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X6401013405MIY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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