Individual
SHATORIA TYSHON THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHCA, LCASA
Contact information
Practice address
429 BILLINGSLEY RD, CHARLOTTE, NC 28211-1007
(704) 445-6900
Mailing address
100 BILLINGSLEY RD, CHARLOTTE, NC 28211-1002
(704) 376-7447
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-22433
NC
101YM0800X
Mental Health Counselor
A13369
NC
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/21/2017
Last updated
03/20/2020
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