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General NPI Number Information
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NPI Number | 1982132247
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Entity Type | Organization
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Legal Business Name | SHIMMEL COUNSELING AGENCY, LLC
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Dates
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Enumeration Date | 05/31/2017
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Last Update Date | 05/31/2017
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Provider Practice Location Address
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Address Line | 950 E MAPLE RD STE 122
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6408
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Country | US
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Telephone | 248-821-2981
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Fax |
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Provider Business Mailing Address
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Address Line | 2329 HARVARD RD
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City | BERKLEY
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State | MI
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Zip | 48072-1751
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Country | US
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Telephone | 248-821-2981
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | DOUGLAS SHIMMEL
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Credential | MA, LLPC
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Telephone | 248-821-2981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 6401012954
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 6401012954
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License Number State | MI
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