Individual
MS. GAYLE BOCKMAN SHELLENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
13 COLONY HOUSE CT, COLUMBIA, SC 29212-3520
(803) 665-0000
(803) 896-5166
Mailing address
13 COLONY HOUSE CT, COLUMBIA, SC 29212-3520
(803) 665-0000
(803) 896-5166
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6940
SC
101YM0800X
Mental Health Counselor
6940
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6940
BOARD OF SOCIAL WORK EXAMINERS
SC
Enumeration date
11/21/2012
Last updated
11/21/2012
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