Provider Demographics
NPI:1326223173
Name:DR SHANYN & ASSOCIATES PC
Entity Type:Organization
Organization Name:DR SHANYN & ASSOCIATES PC
Other - Org Name:CARE COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANYN
Authorized Official - Middle Name:
Authorized Official - Last Name:AYSTA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:704-483-2273
Mailing Address - Street 1:PO BOX 3086
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-3086
Mailing Address - Country:US
Mailing Address - Phone:828-438-8577
Mailing Address - Fax:828-438-8507
Practice Address - Street 1:2318 N HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-8353
Practice Address - Country:US
Practice Address - Phone:704-483-2273
Practice Address - Fax:704-483-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3388103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000988Medicaid