Healthcare Provider Details

I. General information

NPI: 1831869619
Provider Name (Legal Business Name): SHAWANNA HERION
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W EVANS ST STE B
FLORENCE SC
29501-3441
US

IV. Provider business mailing address

901 W EVANS ST STE B
FLORENCE SC
29501-3441
US

V. Phone/Fax

Practice location:
  • Phone: 843-799-0088
  • Fax: 843-407-1067
Mailing address:
  • Phone: 843-799-0088
  • Fax: 843-407-1067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12420
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: