Individual provider Active NPI

Shacara B Burrel, J.D, LCSW

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1104468123
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801105056 Issued in MI
Practice address
2920 W Main St
Kalamazoo, MI 49006-2954
Phone
(269) 888-4046
Fax
(269) 721-6361
NPI assigned
Oct 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 6851105056 MI
Clinical Social Worker 1041C0700X 6801105056 MI Primary
Clinical Social Worker 1041C0700X 6851105056 MI

Addresses

Primary practice location

2920 W Main St
Kalamazoo, MI 49006-2954

Mailing address

PO Box 35
Oshtemo, MI 49077-0035
Phone (231) 670-9761

Other identifiers 2

IdentifierTypeStateIssuer
6801105056OtherMIMSW LIMITED LICENSE
6851105056OtherMILLMSW

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Juris Doctor

State licenses

LicenseStateTypeSpecialty
6851105056MIMDSocial Worker
6801105056MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Becoming Balanced, LLC Social Worker CurrentSince Nov 1, 2022 Accepting new patients
Intentional Journey Counseling Services, PLLC Clinical PastSince Aug 1, 2021 Accepting new patients

Locations

1141 S Rose St
Ste A
Kalamazoo, MI 49001
Phone (269) 344-8700

2970 S 9th St
Ste 9
Kalamazoo, MI 49009
Phone (269) 330-2390

2920 W Main St
Kalamazoo, MI 49006

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1104468123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35",
            "city": "OSHTEMO",
            "state": "MI",
            "postal_code": "490770035",
            "telephone_number": "231-670-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 W MAIN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490062954",
            "telephone_number": "269-888-4046",
            "fax_number": "269-721-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURREL",
        "first_name": "SHACARA",
        "middle_name": "B",
        "credential": "J.D, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851105056",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105056",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851105056",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MSW LIMITED LICENSE",
            "identifier": "6801105056",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LLMSW",
            "identifier": "6851105056",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.