Provider Demographics
NPI:1669627618
Name:SHIGLEY, EMILY ANN (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ANN
Last Name:SHIGLEY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 LAKE LYNN DR
Mailing Address - Street 2:APT 102
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-3452
Mailing Address - Country:US
Mailing Address - Phone:919-630-7434
Mailing Address - Fax:919-784-9184
Practice Address - Street 1:3801 LAKE BOONE TRL
Practice Address - Street 2:SUITE 320
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-2934
Practice Address - Country:US
Practice Address - Phone:919-291-4724
Practice Address - Fax:919-784-9184
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0061591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical