Provider Demographics
NPI:1205620093
Name:SHELTON, HAILE BRYCE
Entity type:Individual
Prefix:
First Name:HAILE
Middle Name:BRYCE
Last Name:SHELTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 HIGH BRIDGE CHASE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5512
Mailing Address - Country:US
Mailing Address - Phone:702-334-9414
Mailing Address - Fax:
Practice Address - Street 1:960 N POINT PKWY STE 450
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-9021
Practice Address - Country:US
Practice Address - Phone:702-334-9414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker