Kirby, Shawna Blake

Kirby, Shawna Blake is an individual health care provider with primary practice located at 1505 Charleston Hwy # 1523, West Columbia SC 29169-5069. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Neuropsychologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Kirby, Shawna Blake can be contacted via phone (803) 497-3640.

Contact Information

Primary practice address
1505 Charleston Hwy # 1523 West Columbia SC 29169-5069
Phone: (803) 497-3640
Fax: (888) 352-7678
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1251 South Carolina
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 1251 South Carolina

Profile Details

NPI number 1174686356
LBN Legal business name Kirby, Shawna Blake
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2006
Last updated Feb 28th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174686356 NPPES
South Carolina MEDICAID PS0613

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