Provider Demographics
NPI:1013276625
Name:SHOVLIN, JAMES R (LPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:SHOVLIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PINE TREE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-1708
Mailing Address - Country:US
Mailing Address - Phone:570-474-2726
Mailing Address - Fax:
Practice Address - Street 1:110 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-3301
Practice Address - Country:US
Practice Address - Phone:570-552-6000
Practice Address - Fax:570-552-6021
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004789101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional