Healthcare Provider Details

I. General information

NPI: 1063382018
Provider Name (Legal Business Name): MARSHBANKS MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 HARTLAND RD
FENTON MI
48430-9568
US

IV. Provider business mailing address

10246 CROUSE RD UNIT 64
HARTLAND MI
48353-7802
US

V. Phone/Fax

Practice location:
  • Phone: 810-373-5941
  • Fax:
Mailing address:
  • Phone: 810-373-5941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE MARSHBANKS
Title or Position: OWNER/ PRIMARY PROVIDER
Credential: LPC CAADC CCS ACS
Phone: 810-373-5941