Provider Demographics
NPI:1881002715
Name:FREEMAN, SHANNA (MA, CACP)
Entity Type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MA, CACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 WISTERIA RD
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-3495
Mailing Address - Country:US
Mailing Address - Phone:843-797-7871
Mailing Address - Fax:843-797-8638
Practice Address - Street 1:96 WISTERIA RD
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-3495
Practice Address - Country:US
Practice Address - Phone:843-797-7871
Practice Address - Fax:843-797-8638
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)