Healthcare Provider Details

I. General information

NPI: 1831672484
Provider Name (Legal Business Name): SHAUNTELL HOWARD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8303 OFFICE PARK DR STE B
DOUGLASVILLE GA
30134-6935
US

IV. Provider business mailing address

4470 WOOD HOLLOW CT
DOUGLASVILLE GA
30134-2010
US

V. Phone/Fax

Practice location:
  • Phone: 678-838-8333
  • Fax:
Mailing address:
  • Phone: 770-670-0858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC012136
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: