Healthcare Provider Details

I. General information

NPI: 1114517000
Provider Name (Legal Business Name): SHELIA DEANNE WESTMORELAND LPC004909
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2021
Last Update Date: 01/25/2021
Certification Date: 01/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 SAVAGE HILL DRIVE
TOCCOA GA
30577
US

IV. Provider business mailing address

40 SAVAGE HILL DRIVE
TOCCOA GA
30577
US

V. Phone/Fax

Practice location:
  • Phone: 470-656-3720
  • Fax:
Mailing address:
  • Phone: 470-656-3720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC004909
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: