Shockley, Reginald Harrison

Shockley, Reginald Harrison is an individual health care provider with primary practice located at 106 Milford St Ste 201 , Salisbury MD 21804. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Shockley, Reginald Harrison can be contacted via phone (410) 334-6961.

Contact Information

Primary practice address
106 Milford St Ste 201 Salisbury MD 21804
Phone: (410) 334-6961
Fax: (410) 334-6960
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 24065 Maryland

Profile Details

NPI number 1619046919
LBN Legal business name Shockley, Reginald Harrison
Credentials LCSW-C
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2006
Last updated Jul 24th, 2018 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1619046919 NPPES
Other 517251 UHC MAMSI GROUP #
Other LM49EA UHC MAMSI GROUP #
Other R968 UHC MAMSI GROUP #
MEDICAID 609550001 UHC MAMSI GROUP #
Other 259147000 UHC MAMSI GROUP #

Popular Providers