# SHANISE BLACKMON INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Living Well Counseling Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538960240
- **Authorized official:** CARMEN SHANISE BLACKMON LCMHC (OWNER/ PROFESSIONAL COUNSELOR)
- **Authorized official phone:** (704) 224-3260

## Contact information

- **Practice address:** 339 ESTHER CIR, KANNAPOLIS, NC 28083-9026
- **Practice address phone:** (704) 224-3260
- **Mailing address:** 339 ESTHER CIR, KANNAPOLIS, NC 28083-9026
- **Mailing address phone:** (704) 224-3260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/20/2025
- **Last updated:** 08/29/2025