Provider Demographics
NPI:1861032567
Name:HOPKINS, SHANIECE G
Entity Type:Individual
Prefix:
First Name:SHANIECE
Middle Name:G
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5316 FOX COVE LN APT B
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-5969
Mailing Address - Country:US
Mailing Address - Phone:336-482-6732
Mailing Address - Fax:
Practice Address - Street 1:5316 FOX COVE LN APT B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-5969
Practice Address - Country:US
Practice Address - Phone:336-482-6732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15449101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional