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General NPI Number Information
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NPI Number | 1730942657
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Entity Type | Organization
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Legal Business Name | SHANNTEL COUNSELING, LLC
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Dates
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Enumeration Date | 02/02/2024
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 223 SEAMASTER RD
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City | ESSEX
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State | MD
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Zip | 21221-5976
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Country | US
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Telephone | 443-622-8755
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Fax |
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Provider Business Mailing Address
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Address Line | 223 SEAMASTER RD
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City | ESSEX
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State | MD
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Zip | 21221-5976
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHANNTEL GLADNEY
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Credential |
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Telephone | 443-622-8755
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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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