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General NPI Number Information
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NPI Number | 1992347751
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Entity Type | Individual
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Provider Name | SHARELL DESHAUN CANNADY MA, LCMHC
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Gender | Female
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 3030 S DEVON ST
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City | CHARLOTTE
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State | NC
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Zip | 28213-5322
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Country | US
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Telephone | 980-292-4018
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Fax |
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Provider Business Mailing Address
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Address Line | 7705 PHILADELPHIA CT APT 308
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City | CHARLOTTE
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State | NC
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Zip | 28216-4587
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Country | US
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Telephone | 704-390-1067
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 15241
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License Number State | NC
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