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Individual

MRS. LISA EVETTE HARRELL SHELLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
QMHP-A, QMHP-C

Contact information

Practice address
323 ELMWOOD CT, VIRGINIA BEACH, VA 23454-3202
(757) 201-2302
Mailing address
323 ELMWOOD CT, VIRGINIA BEACH, VA 23454-3202
(757) 201-2302

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0732005792
VA
101YM0800X
Mental Health Counselor
0733005430
VA
103T00000X
Psychologist
171M00000X
Case Manager/Care Coordinator
251S00000X
Community/Behavioral Health Agency
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other

Enumeration date
11/26/2019
Last updated
11/26/2019
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