Shanasia Victrum, MA

Individual provider Active NPI Mental Health Counselor · Rex, GA

NPI 1255068698 · NPPES record last updated Aug 5, 2022

Key facts

NPI
1255068698
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
177 Hayes Cir
Rex, GA 30273-1543
Phone
(678) 613-3542
NPI assigned
Aug 5, 2022
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

177 Hayes Cir
Rex, GA 30273-1543

Mailing address

177 Hayes Cir
Rex, GA 30273-1543
Phone (678) 613-3542

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address shay@comprehensivefamilycare.org

Other providers in Rex, GA

All providers in Rex, GA · Mental Health Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.