Harrison, Shantelle
Harrison, Shantelle is an sole proprietor health care provider with primary practice located at 5284 Floyd Rd Sw Unit 233 , Mableton GA 30126-6102. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Harrison, Shantelle can be contacted via phone (252) 903-1480.Contact Information
Primary practice address
5284 Floyd Rd Sw Unit 233
Mableton GA 30126-6102
Phone: (252) 903-1480
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW007794 | Georgia |
Profile Details
| NPI number | 1467107045 |
|---|---|
| LBN Legal business name | Harrison, Shantelle |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 13th, 2022 |
| Last updated | Apr 22nd, 2024 - about 5 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467107045 | NPPES |
| Georgia | Other | CSW007794 | LICENSE |
| Georgia | Other | 5535C | LICENSE |
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