| Shelby Counseling, Inc. | |
|
52188 Van Dyke Ave Suite 320 Shelby Township MI 48316-3567 | |
| (586) 323-0176 | |
| (586) 737-7950 |
| Full Name | Shelby Counseling, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 52188 Van Dyke Ave, Shelby Township, Michigan |
| Authorized Official Name and Position | Lisa Irwin (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 5863230176 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelby Counseling, Inc. 52188 Van Dyke Ave Suite 320 Shelby Township MI 48316-3567 Ph: (586) 323-0176 | Shelby Counseling, Inc. 52188 Van Dyke Ave Suite 320 Shelby Township MI 48316-3567 Ph: (586) 323-0176 |
| NPI Number | 1144647892 |
|---|---|
| Provider Enumeration Date | 03/19/2014 |
| Last Update Date | 03/19/2014 |
| Medicare PECOS PAC ID | 1153544739 |
|---|---|
| Medicare Enrollment ID | O20140529001278 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144647892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301008401 (Michigan) | Primary |
| Provider Name | Lisa M Irwin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740371442 PECOS PAC ID: 0244398915 Enrollment ID: I20081024000051 |
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