Healthcare Provider Details

I. General information

NPI: 1295012417
Provider Name (Legal Business Name): SHANNA LEIGH MAY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N CORCORAN ST
DURHAM NC
27701-5015
US

IV. Provider business mailing address

6990 COUNTY HOME RD
AYDEN NC
28513-8508
US

V. Phone/Fax

Practice location:
  • Phone: 323-205-7088
  • Fax: 833-419-0181
Mailing address:
  • Phone: 252-375-5255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020001
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC008009
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18682
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: