Healthcare Provider Details

I. General information

NPI: 1124894886
Provider Name (Legal Business Name): SHELLY WOOD FERRELL LCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 N FRENCH BROAD AVE
ASHEVILLE NC
28801-2602
US

IV. Provider business mailing address

67 WIND STONE DR
ASHEVILLE NC
28804-8806
US

V. Phone/Fax

Practice location:
  • Phone: 828-528-7685
  • Fax:
Mailing address:
  • Phone: 203-247-5366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-29166
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: