Individual
MR. SHAWN KEITH HARTZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPA
Contact information
Practice address
154 MEDICAL PARK LOOP, SYLVA, NC 28779-5271
(828) 319-1080
(828) 631-9280
Mailing address
154 MEDICAL PARK LOOP, SYLVA, NC 28779-5271
(828) 319-1080
(828) 631-9280
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2262
NC
103T00000X
Psychologist
Primary
2262
NC
103TC2200X
Clinical Child & Adolescent Psychologist
2262
NC
103TF0000X
Family Psychologist
2262
NC
103TF0200X
Forensic Psychologist
2262
NC
103TH0100X
Health Service Psychologist
2262
NC
103TP2701X
Group Psychotherapy Psychologist
2262
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107428
—
NC
Enumeration date
02/26/2007
Last updated
04/19/2010
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