Miss Elise Ashley Goulbourne, LLPC is a
Counselor - Professional based in Detroit, Michigan. Miss Elise Ashley Goulbourne is licensed to practice in Michigan (license number 6451022680) and her current practice location is
2995 E Grand Blvd, Detroit, Michigan. She can be reached at her office (for appointments etc.) via phone at
(313) 758-0150.
NPI number for Miss Elise Ashley Goulbourne is 1376966572 and her current mailing address is 2995 E Grand Blvd Ste 1038, Detroit, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1376966572.
Healthcare Provider's Profile
| Full Name | Miss Elise Ashley Goulbourne |
|---|
| Gender | Female |
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| Speciality | Counselor - Professional |
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| Location | 2995 E Grand Blvd, Detroit, Michigan |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1376966572
- Provider Enumeration Date: 01/24/2014
- Last Update Date: 08/01/2023
Medical Identifiers
Medical identifiers for Miss Elise Ashley Goulbourne such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1376966572 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 103TC1900X | Psychologist - Counseling | 6301015813 (Michigan) | Secondary |
| 101YP2500X | Counselor - Professional | 6451022680 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Elise Ashley Goulbourne is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Miss Elise Ashley Goulbourne, LLPC 2995 E Grand Blvd Ste 1038, Detroit, MI 48202-3133 Ph: (313) 758-0150 | Miss Elise Ashley Goulbourne, LLPC 2995 E Grand Blvd, Detroit, MI 48202-3133 Ph: (313) 758-0150 |
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