Organization Active NPI

Shannon Davis Licensed Professional Counseling

  • Professional Counselor
  • Pawley's Island, SC
National Provider Identifier
1952107450
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SHANNON DAVIS LICENSED PROFESSIONAL COUNSELING
Practice address
14323 Ocean Hwy Unit 4103
Pawleys Island, SC 29585-4817
Phone
(843) 608-0884
NPI assigned
Feb 24, 2025
Last updated
Feb 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Julee KrechelNPI 1770929945
Title
Office Manager
Phone
(843) 458-0643

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

14323 Ocean Hwy Unit 4103
Pawleys Island, SC 29585-4817

Mailing address

114 Lake TRL
Pawleys Island, SC 29585-7211

Other practice location 1

103 Queen St Ste D
Georgetown, SC 29440-3633
Phone (843) 602-0884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250417000495 SC Part B Supplier - Clinic/Group Practice 5991220402 Receives reassigned benefits from 1 practitioner
Practice locations: Pawleys Island, SC; Georgetown, SC

National Provider Directory

National Provider Directory

Locations

103 Queen St
Ste D
Georgetown, SC 29440
Phone (843) 602-0884

14323 Ocean Hwy
Unit 4103
Pawleys Island, SC 29585
Phone (843) 310-4650

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1952107450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 LAKE TRL",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295857211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14323 OCEAN HWY UNIT 4103",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295854817",
            "telephone_number": "843-608-0884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Queen St Ste D",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294403633",
            "country_code": "US",
            "telephone_number": "843-602-0884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHANNON DAVIS LICENSED PROFESSIONAL COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "KRECHEL",
        "authorized_official_first_name": "JULEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-458-0643"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawley's Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.