Healthcare Provider Details

I. General information

NPI: 1558537985
Provider Name (Legal Business Name): SUSAN ANN SHIRLEY LMHC,LPC,CRC,CAP,NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 SE FEDERAL HWY # 103V
STUART FL
34994-4531
US

IV. Provider business mailing address

2440 SE FEDERAL HWY # 103V
STUART FL
34994-4531
US

V. Phone/Fax

Practice location:
  • Phone: 337-356-5486
  • Fax:
Mailing address:
  • Phone: 337-356-5486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4451
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number4221
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8882
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number47371
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: