Provider Demographics
NPI:1083238620
Name:COMPREHENSELF
Entity Type:Organization
Organization Name:COMPREHENSELF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORK
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHKRELI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LMSW, QMHP
Authorized Official - Phone:596-214-7787
Mailing Address - Street 1:6218 WINDEMERE LN
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-5383
Mailing Address - Country:US
Mailing Address - Phone:586-214-7787
Mailing Address - Fax:
Practice Address - Street 1:6218 WINDEMERE LN
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48316-5383
Practice Address - Country:US
Practice Address - Phone:586-214-7787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1275609430OtherNPI-1