Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. John Richard Shack, PHD

Individual provider Clinical Psychologist · NPI 1942478706

Dr. John Richard Shack, PHD is a Clinical Psychologist in Douglas, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2008
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

713 Wilderness Dr
Douglas, MI 49406-0140
Phone: (269) 857-8644
Fax: (269) 857-8644
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 6301011374 (MI)

Record details

NPI number1942478706
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedFebruary 14, 2008
Last updated in NPPESFebruary 14, 2008
Mailing address713 Wilderness Drive, P. O. Box 140, Douglas, MI 49406-0140