Individual
MS. SHANATA N EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHCA, LCAS-A
Contact information
Practice address
7910 US HWY 117 S, ROCKY POINT, NC 28457-9431
(910) 259-0668
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
(910) 341-5779
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-29061
NC
101YM0800X
Mental Health Counselor
A19627
NC
101YP2500X
Professional Counselor
Primary
A19627
NC
Other
Enumeration date
07/03/2023
Last updated
06/11/2024
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