Provider Demographics
NPI:1689095226
Name:SHAI COUNSELING SOLUTION, PLLC
Entity Type:Organization
Organization Name:SHAI COUNSELING SOLUTION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:SHAI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:828-773-1054
Mailing Address - Street 1:9650 STRICKLAND RD
Mailing Address - Street 2:SUITE 103-333
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-1902
Mailing Address - Country:US
Mailing Address - Phone:828-773-1054
Mailing Address - Fax:919-977-5757
Practice Address - Street 1:9650 STRICKLAND RD
Practice Address - Street 2:SUITE 103-333
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-1902
Practice Address - Country:US
Practice Address - Phone:828-773-1054
Practice Address - Fax:919-977-5757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-29
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0074401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty