Ellen Rose Tabak in Bloomfield Hills - Clinical
Ellen Rose Tabak - NPI 1396743704
Ellen Rose Tabak is a Clinical in Bloomfield Hills, Michigan. Ellen Rose Tabak practices all healthcare services and medical treatments related to Clinical. The NPI Number for Ellen Rose Tabak is 1396743704. The last update date is 2019-10-07.
Ellen Rose Tabak's current location address is 1960 Golf Ridge Dr, Bloomfield Hills, Michigan. You can contact this provider via phone number 2485389666 and fax number 2485389666. The mailing address for Ellen Rose Tabak is 1960 Golf Ridge Dr, Bloomfield Hills, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ellen Rose Tabak |
|---|---|
| Address | 1960 Golf Ridge Dr, Bloomfield Hills, Michigan |
| Phone Number | 2485389666 |
| Fax Number | 2485389666 |
| Sole Proprietor | N |
| Credentials | ACSW, M.A. |
NPI Number Detail
| NPI Number | 1396743704 |
|---|---|
| Provider Enumeration Date | 2005-07-09 |
| Last Updated Date | 2019-10-07 |
Provider Mailing Address Detail
| Address | 1960 Golf Ridge Dr |
|---|---|
| City | Bloomfield Hills |
| State | Michigan (MI) |
| Post Code | 483021725 |
| Phone Number | 2485389666 |
| Fax Number | 2485389666 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 6801018478 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 382778765 | MI | CIGNA / VENDOR # 1139981 | |
| 750910718 | MI | BLUE CROSS BLUE SHIELD | |
| 247423000 | MAGELLAN BEHAVIORAL OF MI | ||
| 51940-01 | MT CARMEL BEHAVIORAL HLTH | ||
| 9359445 | PRIVATE HEALTHCARE SYSTEM |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Ellen Rose Tabak by the Centers for Medicare & Medicaid Services?
The Ellen Rose Tabak has been issued the NPI (National Provider Identifier) 1396743704, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Ellen Rose Tabak?
The Ellen Rose Tabak is situated at 1960 Golf Ridge Dr, in the city of Bloomfield Hills, state of MI, with the zip code 483021725.
What is Ellen Rose Tabak's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Ellen Rose Tabak is Clinical, and the corresponding taxonomy classification code for this specialized field is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1396743704 to Ellen Rose Tabak?
The Centers for Medicare & Medicaid Services assigned the 1396743704 to Ellen Rose Tabak on 2005-07-09.
When was the information regarding Ellen Rose Tabak most recently updated?
The details pertaining to the Ellen Rose Tabak, including its address, specialty, and other relevant information, were last refreshed on 2019-10-07.