Provider Demographics
NPI:1295322154
Name:PIERCE, SHADAE MARIA (LMSW)
Entity type:Individual
Prefix:
First Name:SHADAE
Middle Name:MARIA
Last Name:PIERCE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SHADAE
Other - Middle Name:MARIA
Other - Last Name:ROBERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:27160 SPRING ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3541
Mailing Address - Country:US
Mailing Address - Phone:313-687-4455
Mailing Address - Fax:
Practice Address - Street 1:20490 ROSELAWN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-1166
Practice Address - Country:US
Practice Address - Phone:313-687-4455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010932021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical