Individual
DR. JAMES HUBERT SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
24159
IL
103T00000X
Psychologist
071002782
IL
103TC0700X
Clinical Psychologist
Primary
071002782
IL
106H00000X
Marriage & Family Therapist
166000265
IL
Other
Enumeration date
06/30/2006
Last updated
05/20/2020
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