Provider Demographics
NPI:1972554780
Name:SHEBROE, VALERIE (PHD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:SHEBROE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7872 ASHBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-8854
Mailing Address - Country:US
Mailing Address - Phone:517-332-4011
Mailing Address - Fax:517-332-7552
Practice Address - Street 1:7872 ASHBROOK DR
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-8854
Practice Address - Country:US
Practice Address - Phone:517-332-4011
Practice Address - Fax:517-332-7552
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007355103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI680C34662OtherBCBSM
MI1032214OtherMCLAREN HEALTH PLAN & HEALTH ADVANTAGE
MI680C34662OtherBCBSM