Individual
MR. DANIEL WATKINS SHATTUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., LCMHC
Contact information
Practice address
2501 ATRIUM DR STE 100, RALEIGH, NC 27607-6452
(919) 763-2760
(919) 359-9705
Mailing address
2501 ATRIUM DR STE 100, RALEIGH, NC 27607-6452
(919) 763-2760
(919) 359-9705
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3398
NC
101YP2500X
Professional Counselor
3398
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102454
—
NC
01
—
75888
BLUE CROSS AND BLUE SHIEL
NC
01
—
E0478
MEDCOST PREFERRED
NC
Enumeration date
05/20/2006
Last updated
12/01/2021
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