# ETHEREDGE AND SHELTON, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164668869
- **Authorized official:** GAY HILL ETHEREDGE LCSW (PRESIDENT)
- **Authorized official phone:** (903) 277-7732

## Contact information

- **Practice address:** 207 E HIRAM ST, ATLANTA, TX 75551-2661
- **Practice address phone:** (903) 796-5061
- **Mailing address:** 1204 HOLLY ST, ATLANTA, TX 75551-1842
- **Mailing address phone:** (903) 796-5061

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 00276 | TX | Yes |
| 1041C0700X | Clinical Social Worker | 02075 | TX | — |

## Other

- **Enumeration date:** 12/30/2008
- **Last updated:** 12/30/2008