Provider Demographics
NPI:1780948075
Name:MOOREFIELD, SHELLEY MARIE (LPC)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:MARIE
Last Name:MOOREFIELD
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:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:ROSE HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28458-0880
Mailing Address - Country:US
Mailing Address - Phone:910-289-2610
Mailing Address - Fax:910-289-4410
Practice Address - Street 1:416 W RIDGE ST
Practice Address - Street 2:
Practice Address - City:ROSE HILL
Practice Address - State:NC
Practice Address - Zip Code:28458-0880
Practice Address - Country:US
Practice Address - Phone:910-289-2610
Practice Address - Fax:910-289-4410
Is Sole Proprietor?:No
Enumeration Date:2012-07-01
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health