Provider Demographics
NPI:1609271840
Name:HORN, SHAYLA TRUETT (BA)
Entity Type:Individual
Prefix:
First Name:SHAYLA
Middle Name:TRUETT
Last Name:HORN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:SHAYLA
Other - Middle Name:DANELLE
Other - Last Name:TRUETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:200 S POST RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-6270
Mailing Address - Country:US
Mailing Address - Phone:704-476-4106
Mailing Address - Fax:704-481-7581
Practice Address - Street 1:200 S POST RD STE 2
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6270
Practice Address - Country:US
Practice Address - Phone:704-476-4106
Practice Address - Fax:704-481-7581
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NC22694101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor