Provider Demographics
NPI:1730309741
Name:SHACKELFORD, APRIL (LMSW, CADC)
Entity Type:Individual
Prefix:MISS
First Name:APRIL
Middle Name:
Last Name:SHACKELFORD
Suffix:
Gender:F
Credentials:LMSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6940 OAK HILL RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-1204
Mailing Address - Country:US
Mailing Address - Phone:810-423-7577
Mailing Address - Fax:
Practice Address - Street 1:2091 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3657
Practice Address - Country:US
Practice Address - Phone:810-732-1652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MI68010936811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)