Provider Demographics
NPI:1477118776
Name:MISSY BEAN LMSW LLC
Entity type:Organization
Organization Name:MISSY BEAN LMSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-202-1146
Mailing Address - Street 1:1850 11 MILE ROAD
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-3001
Mailing Address - Country:US
Mailing Address - Phone:248-202-1146
Mailing Address - Fax:
Practice Address - Street 1:1850 11 MILE ROAD
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-3001
Practice Address - Country:US
Practice Address - Phone:248-202-1146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty