Provider Demographics
NPI:1700127966
Name:SHIRLEY, TODD DAVID (MED NCC)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:DAVID
Last Name:SHIRLEY
Suffix:
Gender:M
Credentials:MED NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FLOWERS DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-1701
Mailing Address - Country:US
Mailing Address - Phone:717-612-1800
Mailing Address - Fax:717-612-1850
Practice Address - Street 1:3 FLOWERS DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-1701
Practice Address - Country:US
Practice Address - Phone:717-612-1800
Practice Address - Fax:717-612-1850
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health