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Organization
LIVING OUT LOUD
Active
Organization
LIVING OUT LOUD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHARLOTTE BEACHEM LMSW (CEO)
(586) 945-4488
Entity
Organization
Contact information
Practice address
22359 SAINT GERTRUDE ST, SAINT CLAIR SHORES, MI 48081-2526
(586) 945-4488
Mailing address
17301 LIVERNOIS AVE, SUITE 158, DETROIT, MI 48221-2758
(586) 738-0488
(586) 766-1248
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801088409
MI
Other
Enumeration date
05/08/2008
Last updated
04/16/2012
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