Provider Demographics
NPI: | 1972363125 |
---|---|
Name: | CEIS PLLC |
Entity type: | Organization |
Organization Name: | CEIS PLLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER, MEDICAL DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JAIME |
Authorized Official - Middle Name: | LYN-ESSIAN |
Authorized Official - Last Name: | TAYLOR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DO |
Authorized Official - Phone: | 248-771-2800 |
Mailing Address - Street 1: | 42505 WOODWARD AVE STE 100 |
Mailing Address - Street 2: | |
Mailing Address - City: | BLOOMFIELD HILLS |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48304-5147 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 248-771-2800 |
Mailing Address - Fax: | 248-856-2939 |
Practice Address - Street 1: | 42505 WOODWARD AVE STE 100 |
Practice Address - Street 2: | |
Practice Address - City: | BLOOMFIELD HILLS |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48304-5147 |
Practice Address - Country: | US |
Practice Address - Phone: | 248-771-2800 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-03-21 |
Last Update Date: | 2025-07-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207QA0000X | Allopathic & Osteopathic Physicians | Family Medicine | Adolescent Medicine | Group - Multi-Specialty |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family | Group - Multi-Specialty |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
No | 163WP0200X | Nursing Service Providers | Registered Nurse | Pediatrics | Group - Multi-Specialty |
No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Multi-Specialty |
No | 363LP0200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics | Group - Multi-Specialty |