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Contact Information

SHADOWS COMMUNITY SUPPORT CENTER LLC
7356 HWY 64 E ALT
ROBERSONVILLE, NC27871
 Phone: 252-795-6662
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for SHADOWS COMMUNITY SUPPORT CENTER LLC · (Female)

NPI # 1487819363
Status Active
Credentials
Entity Individual
Enumeration date 07/21/2008
Last updated 07/21/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • NC License # C004230
  • NC Medicaid 5950083
  • NC Medicaid 6003087
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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