Provider Demographics
NPI:1154861615
Name:STEPHENS, SHAMIKA MASHARIE (MS, LCAS-A)
Entity Type:Individual
Prefix:MRS
First Name:SHAMIKA
Middle Name:MASHARIE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MS, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 CLARINGTON CT
Mailing Address - Street 2:
Mailing Address - City:LUMBER BRIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28357-8781
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:261 CLARINGTON CT
Practice Address - Street 2:
Practice Address - City:LUMBER BRIDGE
Practice Address - State:NC
Practice Address - Zip Code:28357-8781
Practice Address - Country:US
Practice Address - Phone:910-633-0419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-23052101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)