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NPI Code Detail

MEDICARE: SHEBLOOMS COUNSELING PLLC

MEDICARE: SHEBLOOMS COUNSELING PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1013851963
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHEBLOOMS COUNSELING PLLC
Provider Business Mailing Address
First Line : PO BOX 1274
Second Line :
City : WAXHAW
State : NC
Zip : 28173-1012
Country : US
Telephone Number : 704-962-9900
Fax Number :
Provider Business Practice Location Address
First Line : 1235 EAST BLVD E #4303
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203
Country : US
Telephone Number : 704-962-9900
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. DORONISE WRIGHT
Credential : LCSW
Telephone Number : 704-962-9900
Provider Enumeration Date : 04/20/2026
Last Update Date : 06/01/2026

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