Healthcare Provider Details

I. General information

NPI: 1265215206
Provider Name (Legal Business Name): SHAYNA HILLENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2959 12 MILE RD
BERKLEY MI
48072-1413
US

IV. Provider business mailing address

632 N MILL ST
PLYMOUTH MI
48170-1422
US

V. Phone/Fax

Practice location:
  • Phone: 586-202-1145
  • Fax:
Mailing address:
  • Phone: 734-206-7528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: