Organization
JENNY SHEALY, LCSW PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SHEALY LCSW (PRESIDENT)
(828) 279-5369
Entity
Organization
Contact information
Practice address
67 CHARLOTTE ST, ASHEVILLE, NC 28801-2435
(828) 279-5369
Mailing address
67 CHARLOTTE ST, ASHEVILLE, NC 28801-2435
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C005923
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2853495
MEDICARE PTAN
—
05
—
6106848
—
NC
Enumeration date
03/31/2015
Last updated
03/31/2015
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