Provider Demographics
NPI:1780089557
Name:SHIRKEY, CAROL (CAP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:SHIRKEY
Suffix:
Gender:F
Credentials:CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4678 TAMIAMI TRL UNIT 105
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980-2900
Mailing Address - Country:US
Mailing Address - Phone:941-979-5023
Mailing Address - Fax:941-979-5064
Practice Address - Street 1:4678 TAMIAMI TRL UNIT 105
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-2900
Practice Address - Country:US
Practice Address - Phone:941-979-5023
Practice Address - Fax:941-979-5064
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)