Healthcare Provider Details

I. General information

NPI: 1356893960
Provider Name (Legal Business Name): MARRIT LEE SHIERY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2016
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 COLUMBIA AVE E
BATTLE CREEK MI
49015-4469
US

IV. Provider business mailing address

330 COLUMBIA AVE E
BATTLE CREEK MI
49015-4469
US

V. Phone/Fax

Practice location:
  • Phone: 269-964-0513
  • Fax: 855-877-5812
Mailing address:
  • Phone: 269-964-0513
  • Fax: 855-877-5812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801096775
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: