Shannon Miltimore Chapuseaux, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401005891 Issued in MI

Practice address

2045 E West Maple Rd
Suite D-407
Commerce Township, MI 48390-3801

Phone

(248) 624-3811

Fax

(248) 624-0368

NPI assigned

Apr 29, 2008

Last updated

May 1, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Shannon Kathleen Miltimore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1245405323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 ORCHARD LAKE RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412244",
            "telephone_number": "248-858-7766",
            "fax_number": "248-858-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 E WEST MAPLE RD",
            "address_2": "SUITE D-407",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483903801",
            "telephone_number": "248-624-3811",
            "fax_number": "248-624-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPUSEAUX",
        "first_name": "SHANNON",
        "middle_name": "MILTIMORE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401005891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883825",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MILTIMORE",
            "middle_name": "KATHLEEN",
            "prefix": "MISS",
            "credential": "MA, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Commerce Township, MI
• Providers in Commerce Township, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.