Shirley Ann Mack, PH.D., LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401005017 Issued in MI

Practice address

15501 Metropolitan Pkwy
Suite 107
Clinton Township, MI 48036-1684

Phone

(586) 263-3880

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790991990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20466 FLEETWOOD DR",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "482251624",
            "telephone_number": "313-522-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15501 METROPOLITAN PKWY",
            "address_2": "SUITE 107",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480361684",
            "telephone_number": "586-263-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "SHIRLEY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401005017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Maceri, MD
• Martha G Maceroni, MSW
• Paul Machusko
• Gail E. Macintyre, D.O.
• Amy Marie Mack, CCC-SLP
• Vacera M Mack, COTA
• Jacqueline Irene Mackenzie, LMSW
• Tricia Mackool
• Macomb Anesthesia, PC
• Macomb Clinton Center for Wound Care and Hyperbaric Medicine. PLLC

• Mental Health Counselor in Clinton Township, MI
• Providers in Clinton 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 Jul 8, 2007; 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.