Provider Demographics
NPI:1427674381
Name:SHIPMAN, MELISSA SUE (MA, LLC)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:SUE
Last Name:SHIPMAN
Suffix:
Gender:F
Credentials:MA, LLC
Other - Prefix:MRS
Other - First Name:MELISSA
Other - Middle Name:SUE
Other - Last Name:HILLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LLC
Mailing Address - Street 1:706 E MANSION ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068
Mailing Address - Country:US
Mailing Address - Phone:269-268-0675
Mailing Address - Fax:517-905-5906
Practice Address - Street 1:720 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201
Practice Address - Country:US
Practice Address - Phone:734-219-3314
Practice Address - Fax:517-905-5906
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022243101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health