Kersey, Shannon Elizabeth

Kersey, Shannon Elizabeth is an individual health care provider with primary practice located at 4425 Randolph Rd Suite 208, Charlotte NC 28211-2351. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Kersey, Shannon Elizabeth can be contacted via phone (704) 323-6586.

Contact Information

Primary practice address
4425 Randolph Rd Suite 208 Charlotte NC 28211-2351
Phone: (704) 323-6586
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 2531 North Carolina

Profile Details

NPI number 1720190234
LBN Legal business name Kersey, Shannon Elizabeth
Credentials LPA
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Sep 25th, 2012 - about 13 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 1720190234 NPPES
North Carolina MEDICAID 6107171

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