Provider Demographics
NPI:1376095844
Name:EIS, KARLIE
Entity type:Individual
Prefix:
First Name:KARLIE
Middle Name:
Last Name:EIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-2253
Mailing Address - Country:US
Mailing Address - Phone:734-927-4427
Mailing Address - Fax:734-927-4415
Practice Address - Street 1:1308 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-2253
Practice Address - Country:US
Practice Address - Phone:734-927-4427
Practice Address - Fax:734-927-4415
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011205021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical