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General NPI Number Information
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NPI Number | 1942233341
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Entity Type | Organization
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Legal Business Name | SHEPHERD WAY COUNSELING ASSOCIATES
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 7202 W WILKINSON BLVD STE E
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City | BELMONT
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State | NC
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Zip | 28012-6224
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Country | US
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Telephone | 704-825-0541
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Fax | 704-825-0542
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Provider Business Mailing Address
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Address Line | 1001 ASHELY GLEN LN
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City | BELMONT
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State | NC
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Zip | 28012-6524
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Country | US
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Telephone | 704-825-0541
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Fax | 704-825-0542
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Authorized Official
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Title or Position | CLINICAL THERAPSIT
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Name | MRS. MELISSA MCDANIEL
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Credential | M. ED., LPC, NCC
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Telephone | 704-825-0541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4521
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License Number State | NC
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