Provider Demographics
NPI:1891087342
Name:WOODSON-CORLEY, SHELLEY (LPC)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:WOODSON-CORLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 26TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-3126
Mailing Address - Country:US
Mailing Address - Phone:202-316-3161
Mailing Address - Fax:
Practice Address - Street 1:3739 12TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2539
Practice Address - Country:US
Practice Address - Phone:202-316-3161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC253101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional