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General NPI Number Information
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NPI Number | 1154146058
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Entity Type | Individual
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Provider Name | CRAIG SHELLENBERGER MS
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Gender | Male
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 255 S 17TH ST STE 2121
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6211
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Country | US
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Telephone | 267-225-8526
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 MORGAN AVE
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City | CINNAMINSON
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State | NJ
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Zip | 08077-2729
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Country | US
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Telephone | 856-404-3464
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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