Provider Demographics
NPI:1255620605
Name:HANKINS, SHELLEY B (LPC)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:B
Last Name:HANKINS
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 1:110 W CRAWFORD ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-4201
Mailing Address - Country:US
Mailing Address - Phone:706-280-3286
Mailing Address - Fax:
Practice Address - Street 1:110 W CRAWFORD ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-4201
Practice Address - Country:US
Practice Address - Phone:706-280-3286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4989101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4989OtherLPC