Provider Demographics
NPI:1427672864
Name:SHELTON, BRITTANEYROSE (LLMSW)
Entity type:Individual
Prefix:MS
First Name:BRITTANEYROSE
Middle Name:
Last Name:SHELTON
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:BRITTANEY
Other - Middle Name:ROSE
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LLMSW
Mailing Address - Street 1:21751 W 11 MILE RD STE 114
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3779
Mailing Address - Country:US
Mailing Address - Phone:248-905-1389
Mailing Address - Fax:
Practice Address - Street 1:21751 W 11 MILE RD STE 114
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-3779
Practice Address - Country:US
Practice Address - Phone:248-905-1389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011154121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical