Healthcare Provider Details

I. General information

NPI: 1780506915
Provider Name (Legal Business Name): SHELBY BRENNAN BRENNAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42627 GARFIELD RD STE 217
CLINTON TOWNSHIP MI
48038-5032
US

IV. Provider business mailing address

37411 STONEGATE CIR
CLINTON TOWNSHIP MI
48036-2965
US

V. Phone/Fax

Practice location:
  • Phone: 586-203-2715
  • Fax:
Mailing address:
  • Phone: 586-231-4272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: