Provider Demographics
NPI:1952596728
Name:SITTON, SHASTA (MS, LMHC, LPC)
Entity type:Individual
Prefix:
First Name:SHASTA
Middle Name:
Last Name:SITTON
Suffix:
Gender:F
Credentials:MS, LMHC, LPC
Other - Prefix:
Other - First Name:SHASTA
Other - Middle Name:
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:5215 TURTLE LAKE RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:HILLMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49746-8000
Mailing Address - Country:US
Mailing Address - Phone:989-351-9091
Mailing Address - Fax:
Practice Address - Street 1:5215 TURTLE LAKE RD UNIT 2
Practice Address - Street 2:
Practice Address - City:HILLMAN
Practice Address - State:MI
Practice Address - Zip Code:49746-8000
Practice Address - Country:US
Practice Address - Phone:989-351-9091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60068109101YM0800X
MI6301016685101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional