Provider Demographics
NPI:1285182170
Name:LOUISOR, SHIRLEY (NCC, LPC)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:LOUISOR
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 CHATHAM SQUARE OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2544
Mailing Address - Country:US
Mailing Address - Phone:540-373-1200
Mailing Address - Fax:540-373-1280
Practice Address - Street 1:404 CHATHAM SQUARE OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2544
Practice Address - Country:US
Practice Address - Phone:540-373-1200
Practice Address - Fax:540-373-1280
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006762101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional