Healthcare Provider Details

I. General information

NPI: 1982586673
Provider Name (Legal Business Name): SHELLVIA CEARNAL GILL LMSW, LCSW-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHELLVIA L CEARNAL LMSW, LCSWA

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 N BROAD ST E STE 201
ANGIER NC
27501-5638
US

IV. Provider business mailing address

8 N BROAD ST E STE 201
ANGIER NC
27501-5638
US

V. Phone/Fax

Practice location:
  • Phone: 919-375-8392
  • Fax: 919-460-3119
Mailing address:
  • Phone: 919-375-8392
  • Fax: 919-460-3119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number16054
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023167
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: