Provider Demographics
NPI:1235877853
Name:RYCHENER, SHELLEY ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:ELIZABETH
Last Name:RYCHENER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11064 MARGARET ETTA
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-8585
Mailing Address - Country:US
Mailing Address - Phone:734-945-5515
Mailing Address - Fax:
Practice Address - Street 1:11064 MARGARET ETTA
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-8585
Practice Address - Country:US
Practice Address - Phone:734-945-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010718481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical