Provider Demographics
NPI:1750604849
Name:LAWSON, SHELLEY S (LPC, CSAC)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:S
Last Name:LAWSON
Suffix:
Gender:F
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8119 DAVMAR LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-2151
Mailing Address - Country:US
Mailing Address - Phone:540-207-9622
Mailing Address - Fax:
Practice Address - Street 1:150 OLDE GREENWICH DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-4063
Practice Address - Country:US
Practice Address - Phone:540-207-9622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710101550101YA0400X
VA0701003480101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)