MEDICARE: SHYLEXIA HILL

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	101YM0800X	Mental Health Counselor	6451024157	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285226696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHYLEXIA HILL

Provider Business Mailing Address
First Line	:	20679 KENSINGTON CT APT 212
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-3813
Country	:	US
Telephone Number	:	754-301-0461
Fax Number	:

Provider Business Practice Location Address
First Line	:	20679 KENSINGTON CT APT 212
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-3813
Country	:	US
Telephone Number	:	754-301-0461
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2021
Last Update Date	:	02/02/2026

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Directions to “ SHYLEXIA HILL ” Practice Location

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