Provider Demographics
NPI:1083183255
Name:SHEIN, DAVID (LCSW, CADC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SHEIN
Suffix:
Gender:M
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 WASHAM GREEN LN
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-0450
Mailing Address - Country:US
Mailing Address - Phone:312-519-1180
Mailing Address - Fax:
Practice Address - Street 1:9723 NORTHCROSS CENTER CT STE J
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7301
Practice Address - Country:US
Practice Address - Phone:312-519-1180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-17
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0204141041C0700X
NCC013481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical