Shannon Conz, M.A., L.L.P.
Individual provider Active NPI Clinical Psychologist · Berkley, MI
NPI 1710248034 · NPPES record last updated Jun 4, 2012
Key facts
- NPI
- 1710248034
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 6301011525 (MI)
- Practice address
- 3250 Coolidge Hwy
Suite 201
Berkley, MI 48072-1693 - Phone
- (734) 218-0891
- NPI assigned
- Jun 4, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301011525 | MI | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301011525 | MI | Yes |
Addresses
Primary practice location
3250 Coolidge Hwy
Suite 201
Berkley, MI 48072-1693
Mailing address
3250 Coolidge Hwy
Suite 201
Berkley, MI 48072-1693
Phone (734) 218-0891
Other providers in Berkley, MI
- Clifford M Buchman DO PC
- Michael Andrew Colling
- Colin J Colter
- Jennifer Connelly
- Contemporary Dentistry Berkley PLLC
- Coolidge Pharmacy
- Haley Coolsaet
- Corinn Cramer
- Maureen Renee-Strasser Creal
- Lynell Dennis Crew
All providers in Berkley, MI · Clinical Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.