Individual
MRS. SHANTELLE HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5284 FLOYD RD SW UNIT 233, MABLETON, GA 30126-6102
(252) 903-1480
Mailing address
5284 FLOYD RD SW UNIT 233, MABLETON, GA 30126-6102
(252) 903-1480
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW007794
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5535C
LICENSE
AL
01
—
CSW007794
LICENSE
GA
Enumeration date
02/13/2022
Last updated
03/31/2025
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