Provider Demographics
NPI:1376643429
Name:BURNS, SHEILA RENAE (LPC, LBSW, CAADC)
Entity Type:Individual
Prefix:MISS
First Name:SHEILA
Middle Name:RENAE
Last Name:BURNS
Suffix:
Gender:F
Credentials:LPC, LBSW, CAADC
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:RENAE
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, CAADC, LBSW
Mailing Address - Street 1:2195 SOUTHWAY DR
Mailing Address - Street 2:
Mailing Address - City:GRASS LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49240-8704
Mailing Address - Country:US
Mailing Address - Phone:810-844-4018
Mailing Address - Fax:
Practice Address - Street 1:180 LITTLE LAKE DR STE 4
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6219
Practice Address - Country:US
Practice Address - Phone:734-794-3777
Practice Address - Fax:734-794-3771
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68020723151041C0700X
MI6401008110101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical