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Individual
ELEANOR LOUISE DOUGHERTY
Active
Individual
ELEANOR LOUISE DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW-C/M.DCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3446- 123
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
6801069892
MI
101YM0800X
Mental Health Counselor
3446- 123
WI
101YM0800X
Mental Health Counselor
6801069892
MI
101YP2500X
Professional Counselor
3446- 123
WI
101YP2500X
Professional Counselor
6801069892
MI
1041C0700X
Clinical Social Worker
3446-123
WI
1041C0700X
Clinical Social Worker
Primary
6801069892
MI
106H00000X
Marriage & Family Therapist
6801069892
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0897996
BCBSM PIN
MI
01
—
170082-000
MAGELLAN INDIVIDUAL ID
—
01
—
8008979960
BCBSM PIN
MI
Enumeration date
01/23/2006
Last updated
01/07/2010
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