Individual
CHARLES J SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC PHD
Contact information
Practice address
224 GREAT BRIDGE BLVD, CHESAPEAKE COMM SERV BOARD, CHESAPEAKE, VA 23320
(757) 547-9334
(757) 819-6292
Mailing address
PO BOX 1647, 224 GREAT BRIDGE BLVD CHESAPEAKE COMMUNITY SERVICES BOA, CHESAPEAKE, VA 23320
(757) 547-9334
(757) 819-6292
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701000523
VA
106H00000X
Marriage & Family Therapist
0717000221
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
083108
SENTARA
VA
01
—
238960
TRIGON
VA
Enumeration date
11/16/2006
Last updated
05/24/2010
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