MEDICARE: SHEILA DAY COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	6801101816	MI

General Provider Information

NPI Number	:	1124519863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHEILA DAY COUNSELING LLC

Provider Business Mailing Address
First Line	:	12785 WILDERNESS TRL
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-7637
Country	:	US
Telephone Number	:	616-551-8044
Fax Number	:

Provider Business Practice Location Address
First Line	:	923 S BEECHTREE ST STE 10
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-2306
Country	:	US
Telephone Number	:	616-551-7776
Fax Number	:	616-741-1326

Authorized Official
Title or Position	:	LMSW CADC
Name	:	SHEILA DAY
Credential	:
Telephone Number	:	616-551-7776

Provider Enumeration Date	:	05/29/2018
Last Update Date	:	01/13/2020

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