# SHANNON KERSEY, LPA

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

## Provider details

- **NPI number:** 1164708228
- **Authorized official:** MS. SHANNON KERSEY (SOLE PROPRIETOR)
- **Authorized official phone:** (704) 323-6586

## Contact information

- **Practice address:** 4425 RANDOLPH RD, SUITE 208, CHARLOTTE, NC 28211-2351
- **Practice address phone:** (704) 323-6586
- **Mailing address:** 4425 RANDOLPH RD, SUITE 208, CHARLOTTE, NC 28211-2351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 2531 | NC | Yes |

## Other

- **Enumeration date:** 11/02/2011
- **Last updated:** 11/02/2011