Healthcare Provider Details

I. General information

NPI: 1821912080
Provider Name (Legal Business Name): SHAKIRA HARRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 E RAILROAD AVE
MONCKS CORNER SC
29461-3686
US

IV. Provider business mailing address

127 VENICE ST
SUMMERVILLE SC
29483-8344
US

V. Phone/Fax

Practice location:
  • Phone: 843-972-7662
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18977
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: