Healthcare Provider Details

I. General information

NPI: 1740865997
Provider Name (Legal Business Name): BRITTANY NICOLE SHUPE-SAWYER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANY SHUPE LMSW

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8005 MAIN ST STE 10
DEXTER MI
48130-1027
US

IV. Provider business mailing address

8005 MAIN ST STE 10
DEXTER MI
48130-1027
US

V. Phone/Fax

Practice location:
  • Phone: 734-531-8819
  • Fax: 734-339-2238
Mailing address:
  • Phone: 734-531-8819
  • Fax: 734-339-2238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801094491
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: