Shavonn N Burgess, M.A., LPC
Counselor in Southgate, MI. Individual provider (NPI-1).
NPI number1356602452
StatusActive
Last updated in NPPESNov 7, 2016
Details
- NPI
- 1356602452
- Entity type
- Individual (NPI-1)
- Name
- Shavonn N Burgess
- Credential
- M.A., LPC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 5, 2012
- Last updated
- Nov 7, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | 6401011031 | MI | Yes |
Practice location
13101 Allen RdSouthgate, MI 48195-2216
Phone 734-785-7700
Mailing address
27056 Aberdeen StSouthfield, MI 48076-3667
Phone 734-785-7704
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 41 Counselor providers in Southgate · All 2,117 providers in Southgate
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