Shannon Dougherty Canu, LPC
Individual provider Active NPI Professional Counselor · Statesboro, GA
NPI 1447909437 · NPPES record last updated Mar 18, 2022
Key facts
- NPI
- 1447909437
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC012769 (GA)
- Practice address
- 27 S Main St
Statesboro, GA 30458-5245 - Phone
- (912) 225-3769
- NPI assigned
- Mar 18, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC012769 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brave Tomorrow Counseling and Consulting | Current |
Accepting new patients | |
| Brave Tomorrow Counseling and Consulting | Past |
Accepting new patients |
Locations
27 S Main St
Statesboro, GA 30458
Phone (912) 225-3769
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC012769 | GA | Yes |
Addresses
Primary practice location
27 S Main St
Statesboro, GA 30458-5245
Mailing address
PO Box 1242
Statesboro, GA 30459-1242
Other providers in Statesboro, GA
- Jodi Kristen Caldwell
- Valerie Campbell
- Candler Internal Medicine
- Shonna Canicatti
- Alison Cannon
- John Domenic Capachione
- Presley Caplinger
- Kayla Capotosti
- Cardiovascular Associates of Eastern Georgia
- Thomas Carico
All providers in Statesboro, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.