Individual
SHAWN PATRICK MCNULTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, NCC, M.ED.
Contact information
Practice address
COLONIAL BEHAVIORAL HEALTH, 1657 MERRIMAC TRAIL, WILLIAMSBURG, VA 23185
(757) 220-3200
(757) 903-4992
Mailing address
1769 JAMESTOWN RD STE 101, WILLIAMSBURG, VA 23185-2310
(757) 952-6767
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
0701007505
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701007505
LICENSED PROFESSIONAL COUNSELOR
VA
Enumeration date
07/03/2017
Last updated
10/24/2018
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