Healthcare Provider Details

I. General information

NPI: 1376643429
Provider Name (Legal Business Name): SHEILA RENAE BURNS LPC, LBSW, CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEILA RENAE BURNS LPC, CAADC, LBSW

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 06/23/2023
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 LITTLE LAKE DR STE 4
ANN ARBOR MI
48103-6219
US

IV. Provider business mailing address

2195 SOUTHWAY DR
GRASS LAKE MI
49240-8704
US

V. Phone/Fax

Practice location:
  • Phone: 734-794-3777
  • Fax: 734-794-3771
Mailing address:
  • Phone: 810-844-4018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6802072315
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401008110
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: