Individual
MR. JEFFERY EVERETT SHIVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12007 LINWOOD ST, DETROIT, MI 48206-1107
(313) 867-1090
Mailing address
354 CHARTERHOUSE CT, CANTON, MI 48188-1520
(734) 625-4524
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/28/2015
Last updated
08/12/2025
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