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Individual

SCOTT A SHEPHERD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
HUMAN SERVICES COORD

Contact information

Practice address
403 STONEY LANDING ROAD, MONCKS CORNER, SC 29461-3967
(843) 761-8282
(843) 761-7308
Mailing address
403 STONEY LANDING ROAD, MONCKS CORNER, SC 29461-3967
(843) 761-8282
(843) 761-7308

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
00082652
NC
101YM0800X
Mental Health Counselor
7367
NC
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6005782
NC
Enumeration date
07/29/2009
Last updated
01/13/2011
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