Doughty, Shannon S

Doughty, Shannon S is an sole proprietor health care provider with primary practice located at 1902 Old Parsonage Rd , Charleston SC 29414-6205. She recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as her primary health care specialty. Doughty, Shannon S can be contacted via phone (843) 259-8853.

Contact Information

Primary practice address
1902 Old Parsonage Rd Charleston SC 29414-6205
Phone: (843) 259-8853
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X

Profile Details

NPI number 1700947751
LBN Legal business name Doughty, Shannon S
Credentials PHD, BCBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 13th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700947751 NPPES
South Carolina MEDICAID WP8971

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