Provider Demographics
NPI:1881370344
Name:MINNICK, SHEILA (LPC)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:MINNICK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SHELIA
Other - Middle Name:
Other - Last Name:MINNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30164 WHITE HALL CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1938
Mailing Address - Country:US
Mailing Address - Phone:248-894-0213
Mailing Address - Fax:
Practice Address - Street 1:30164 WHITE HALL CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1938
Practice Address - Country:US
Practice Address - Phone:248-894-0213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010594101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101Y00000XBehavioral Health & Social Service ProvidersCounselor