Lorie Wagner Shelton, BA, MA

Individual provider Active NPI Mental Health Counselor · Pfafftown, NC

NPI 1164259693 · NPPES record last updated Sep 18, 2024

Key facts

NPI
1164259693
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
A20556 (NC)
Practice address
7165 Reynolda Rd
Pfafftown, NC 27040-8417
Phone
(336) 406-8031
NPI assigned
Sep 18, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Arts, Master of Arts

State licenses

LicenseStateTypeSpecialty
A20556NCMDMental Health Counselor
CTB-2024-0661NMMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CTB-2024-0661 NM
Mental Health Counselor 101YM0800X A20556 NC Yes

Addresses

Primary practice location

7165 Reynolda Rd
Pfafftown, NC 27040-8417

Mailing address

7165 Reynolda Rd
Pfafftown, NC 27040-8417
Phone (336) 406-8031

Other providers in Pfafftown, NC

All providers in Pfafftown, NC · Mental Health Counselor in North Carolina

Sources for this page

Verify at the official NPI Registry.