Wallace, Shelvey Jean

Wallace, Shelvey Jean is an sole proprietor health care provider with primary practice located at 5306 Nc Highway 55 Ste 105 , Durham NC 27713-7812. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wallace, Shelvey Jean can be contacted via phone (919) 457-1517.

Contact Information

Primary practice address
5306 Nc Highway 55 Ste 105 Durham NC 27713-7812
Phone: (919) 457-1517
Fax: (919) 363-7697
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LCAS-21629 North Carolina
Behavioral Health & Social Service Providers / Clinical 1041C0700X C010042 North Carolina

Profile Details

NPI number 1588900989
LBN Legal business name Wallace, Shelvey Jean
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 13th, 2012
Last updated Oct 13th, 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.

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