Provider Demographics
NPI:1790735785
Name:GARRETT, SHIRLEY B (PSYD, LPC)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:B
Last Name:GARRETT
Suffix:
Gender:F
Credentials:PSYD, LPC
Other - Prefix:DR
Other - First Name:SHIRLEY
Other - Middle Name:BAILEY
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, LPC
Mailing Address - Street 1:117 LONGWOOD DR SW
Mailing Address - Street 2:SUITE C
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4554
Mailing Address - Country:US
Mailing Address - Phone:256-539-0086
Mailing Address - Fax:256-538-0118
Practice Address - Street 1:117 LONGWOOD DR SW
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4554
Practice Address - Country:US
Practice Address - Phone:256-539-0086
Practice Address - Fax:256-538-0118
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1195101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional