Provider Demographics
NPI:1922577246
Name:CHEEKS, SHEILA MARIE
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARIE
Last Name:CHEEKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13134 BIRWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48238-3004
Mailing Address - Country:US
Mailing Address - Phone:313-610-5690
Mailing Address - Fax:313-871-6969
Practice Address - Street 1:1600 PINGREE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48206-2436
Practice Address - Country:US
Practice Address - Phone:313-871-4332
Practice Address - Fax:313-871-4332
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6411006637101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional