Healthcare Provider Details

I. General information

NPI: 1770468167
Provider Name (Legal Business Name): SHAKEMA TERRELL DASHIELL MS, MA, LAPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 BUSTLETON AVE STE 300
PHILADELPHIA PA
19152-3330
US

IV. Provider business mailing address

7901 BUSTLETON AVE STE 300
PHILADELPHIA PA
19152-3330
US

V. Phone/Fax

Practice location:
  • Phone: 215-537-5367
  • Fax:
Mailing address:
  • Phone: 215-537-5367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberAPC001484
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC001484
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: