Staten, Shasta Gabrielle
Staten, Shasta Gabrielle is an individual health care provider with primary practice located at 5200 Park Rd Ste 218B , Charlotte NC 28209-3650. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Staten, Shasta Gabrielle can be contacted via phone (866) 700-1606.Contact Information
Primary practice address
5200 Park Rd Ste 218B
Charlotte NC 28209-3650
Phone: (866) 700-1606
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 9182 | North Carolina |
Profile Details
| NPI number | 1124363718 |
|---|---|
| LBN Legal business name | Staten, Shasta Gabrielle |
| Credentials | MED, LPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 7th, 2012 |
| Last updated | Jun 23rd, 2021 - about 5 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.
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