Provider Demographics
NPI:1225573181
Name:NORTH, SHAMBRICKA (LMSW)
Entity Type:Individual
Prefix:
First Name:SHAMBRICKA
Middle Name:
Last Name:NORTH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 PELHAM DR
Mailing Address - Street 2:H301
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-1341
Mailing Address - Country:US
Mailing Address - Phone:202-415-9085
Mailing Address - Fax:
Practice Address - Street 1:501 PELHAM DR
Practice Address - Street 2:H301
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-1341
Practice Address - Country:US
Practice Address - Phone:202-415-9085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG50081775104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker