Provider Demographics
NPI:1366873549
Name:SIMPLE HARVEST PLLC
Entity type:Organization
Organization Name:SIMPLE HARVEST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BYLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-943-6176
Mailing Address - Street 1:28200 7 MILE RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3794
Mailing Address - Country:US
Mailing Address - Phone:248-943-6176
Mailing Address - Fax:
Practice Address - Street 1:26247 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-5335
Practice Address - Country:US
Practice Address - Phone:248-357-2171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801078549251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health