Healthcare Provider Details

I. General information

NPI: 1427674381
Provider Name (Legal Business Name): MELISSA SUE SHIPMAN M.A., L.L.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA SUE HILLMAN M.A., L.L.C.

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 E MICHIGAN AVE STE 209
JACKSON MI
49202-3765
US

IV. Provider business mailing address

706 E MANSION ST
MARSHALL MI
49068
US

V. Phone/Fax

Practice location:
  • Phone: 517-539-1216
  • Fax:
Mailing address:
  • Phone: 269-268-0675
  • Fax: 517-905-5906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451022243
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: