Provider Demographics
NPI:1376858225
Name:PICKETT, SHAYLA KAPRICE (MS, LLPC)
Entity Type:Individual
Prefix:MS
First Name:SHAYLA
Middle Name:KAPRICE
Last Name:PICKETT
Suffix:
Gender:F
Credentials:MS, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 ANNA DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-5223
Mailing Address - Country:US
Mailing Address - Phone:734-787-5878
Mailing Address - Fax:
Practice Address - Street 1:6825 ANNA DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-5223
Practice Address - Country:US
Practice Address - Phone:734-787-5878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011987101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health