Provider Demographics
NPI:1073812145
Name:SHREVE, CHRIS ALLEN (PHD, LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:ALLEN
Last Name:SHREVE
Suffix:
Gender:M
Credentials:PHD, LPC, NCC
Other - Prefix:DR
Other - First Name:CHRIS
Other - Middle Name:A
Other - Last Name:SHREVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:30100 TELEGRAPH RD STE 470
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4564
Mailing Address - Country:US
Mailing Address - Phone:313-587-7388
Mailing Address - Fax:734-629-1778
Practice Address - Street 1:30100 TELEGRAPH RD STE 470
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4564
Practice Address - Country:US
Practice Address - Phone:313-587-7388
Practice Address - Fax:734-629-1778
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007298101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health