Provider Demographics
NPI:1801192745
Name:MCCAMMON, SHAMEKA (MED,BCBA)
Entity Type:Individual
Prefix:
First Name:SHAMEKA
Middle Name:
Last Name:MCCAMMON
Suffix:
Gender:F
Credentials:MED,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 MEADES CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-7820
Mailing Address - Country:US
Mailing Address - Phone:925-236-0494
Mailing Address - Fax:888-592-0957
Practice Address - Street 1:214 MEADES CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-7820
Practice Address - Country:US
Practice Address - Phone:925-236-0494
Practice Address - Fax:888-592-0957
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1-13-12745103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst