Provider Demographics
NPI:1346785409
Name:TREECE, SHEALAH (MSW)
Entity Type:Individual
Prefix:MRS
First Name:SHEALAH
Middle Name:
Last Name:TREECE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29990 BRIARBANK CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-4672
Mailing Address - Country:US
Mailing Address - Phone:313-433-8428
Mailing Address - Fax:
Practice Address - Street 1:17600 W 11 MILE RD
Practice Address - Street 2:STE 100
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076-4722
Practice Address - Country:US
Practice Address - Phone:248-327-7046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010131921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical