Shelton, Lisa Patrice
Shelton, Lisa Patrice is an sole proprietor health care provider with primary practice located at 250 Executive Park Blvd Ste 120 , Winston Salem NC 27103-1534. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Shelton, Lisa Patrice can be contacted via phone (336) 770-2477.Contact Information
Primary practice address
250 Executive Park Blvd Ste 120
Winston Salem NC 27103-1534
Phone: (336) 770-2477
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 17438 | Illinois |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 25760 | North Carolina |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 15221 | North Carolina |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 180.008438 | Illinois |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 180.008438 | Illinois |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | S15221 | North Carolina |
Profile Details
| NPI number | 1104090745 |
|---|---|
| LBN Legal business name | Shelton, Lisa Patrice |
| Credentials | MS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 15th, 2008 |
| Last updated | Mar 21st, 2023 - about 3 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104090745 | NPPES |
| Wisconsin | MEDICAID | 39168700 |
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