Individual
SHANNON NICOLE MAHMUTOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCASA, LCMHCA, MA
Contact information
Practice address
16507 NORTHCROSS DR STE F, HUNTERSVILLE, NC 28078-5082
(704) 277-8197
Mailing address
5006 HOUNDSCROFT RD, INDIAN TRAIL, NC 28079-8818
(980) 402-2686
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-26801
NC
101YM0800X
Mental Health Counselor
A16640
NC
101YP2500X
Professional Counselor
Primary
A16640
NC
Other
Enumeration date
10/11/2021
Last updated
11/12/2021
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