Individual
SHANNON CUTSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LCP
Contact information
Practice address
420 N CENTER DR STE 239B, NORFOLK, VA 23502-0014
(757) 282-6309
(757) 282-6309
Mailing address
420 N CENTER DR STE 239B, NORFOLK, VA 23502-0014
(757) 282-6309
(757) 282-6309
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701006669
VA
103TC0700X
Clinical Psychologist
Primary
0810007357
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0810007357
PHD LICENSE
VA
Enumeration date
06/10/2016
Last updated
05/17/2023
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