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Organization
SOUTHERN HEALTHCARE NETWORK
Active
Organization
SOUTHERN HEALTHCARE NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANTRELL SHELTON LCASA (DIRECTOR)
(910) 263-9570
Entity
Organization
Contact information
Practice address
707 MURCHISON RD, FAYETTEVILLE, NC 28301-7012
(910) 209-4550
Mailing address
111 LAMON ST, 103 C, FAYETTEVILLE, NC 28301-7012
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
09/02/2015
Last updated
09/21/2015
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