Organization
UNVALED PSYCHOLOGICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON CUTSHALL PHD (OWNER)
(757) 282-6309
Entity
Organization
Contact information
Practice address
420 N CENTER DR STE 239B, NORFOLK, VA 23502-0014
(757) 282-6309
(757) 282-6309
Mailing address
420 N CENTER DR STE 239B, NORFOLK, VA 23502-0014
(757) 282-6309
(757) 282-6309
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701006669
VA
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0810007357
PHD LICENSE
VA
Enumeration date
10/10/2017
Last updated
05/31/2022
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