PHYLLIS ANN SHANKLIN (NPI# 1386200848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386200848 |
| Entity Type | Individual |
| Full Name | PHYLLIS ANN SHANKLIN |
| Credential | LCSW |
| Practice Address |
123 Professional Park Dr Ste 101 Mooresville NC 28117 |
| Mailing Address |
123 Professional Park Dr Mooresville NC 28117-5524 |
| Practice Telephone | 7043997976 |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2019-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3549 N Sharon Amity Rd Ste 203, Charlotte, NC 282052975 | 7044691243 |
| Street Address |
123 PROFESSIONAL PARK DR STE 101 |
| City | MOORESVILLE |
| State | NC |
| Zip Code | 28117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518099910 | Nzinga Ajabu Harrison | Psychiatry & Neurology | 123 Professional Park Dr Ste 101, Mooresville, NC 28117-5516 | 2007-03-12 |
| 1427698604 | Michael Doyle | Registered Nurse | 123 Professional Park Dr Ste 101, Mooresville, NC 28117-5516 | 2020-01-15 |
| 1477103810 | Christina M Stone | Registered Nurse | 123 Professional Park Dr Ste 101, Mooresville, NC 28117-5516 | 2019-09-18 |
| 1891349155 | Eleanor Health Professional Nc, Pllc | 123 Professional Park Dr Ste 101, Mooresville, NC 28117-5516 | 2019-07-25 | |
| 1770037699 | Veronica Moeller | Counselor | 123 Professional Park Dr Ste 101, Mooresville, NC 28117 | 2016-08-09 |
| 1558775163 | Megan Rhyne-cousar | Family Medicine | 123 Professional Park Dr Ste 101, Mooresville, NC 28117-5516 | 2014-06-12 |
| 1790110146 | Mooresville Ppm LLC | Surgery | 123 Professional Park Dr Ste 101, Mooresville, NC 28117-5516 | 2013-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891356648 | Teleoptometric Service, P.C. | Optometrist | 392 Talbert Rd, Mooresville, NC 28117 | 2019-06-24 |
| 1992268544 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 392 Talbert Rd., Mooresville, NC 28117 | 2019-04-10 |
| 1982178042 | Langtree Endoscopy Center, LLC | Clinic/Center | 106 Alexander Bank Drive, Suite 101, Mooresville, NC 28117 | 2019-01-11 |
| 1679044416 | May and Associates Therapy Center | Psychologist | 862 Brawley School Road, Suite 202, Mooresville, NC 28117 | 2018-12-05 |
| 1700360153 | Sabrina Chabot Hutchinson | Physical Therapist | 508 Williamson Rd, Suite 200, Mooresville, NC 28117 | 2018-09-21 |
| 1992284327 | Presbyterian Imaging Centers LLC | Radiology | 106 Langtree Village Dr # 201, Mooresville, NC 28117 | 2018-08-07 |
| 1073091310 | Jenelle Donzelli Nemeth | Registered Nurse | 102 Sapphire Drive, Mooresville, NC 28117 | 2018-07-30 |
| 1912497496 | Patsharx LLC | Pharmacy | 480 River Hwy, Suite A, Mooresville, NC 28117 | 2018-05-10 |
| 1427502434 | Counseling Service At Lake Norman, Pllc | Community/Behavioral Health | 18117 W. Catawba Avenue, Cornelius, NC 28117 | 2016-08-08 |
| 1447605928 | Renewal Counseling, Pllc | Counselor | 125 Commerce Park Rd., Suite 102, Mooresville, NC 28117 | 2016-05-03 |
| Find all providers in zip 28117 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881201630 | Flourish Counseling and Consulting | Social Worker | 122 Backstretch Ln, Mooresville, NC 28117-8071 | 2020-09-25 |
| 1881208437 | Jennifer Claire Tackitt | Social Worker | 561 Indianapolis Rd, Mooresville, IN 46158-1271 | 2020-09-01 |
| 1235741265 | Raheem Forsythe | Social Worker | 276 E Catawba Ave, Mooresville, NC 28115-2657 | 2020-08-20 |
| 1295347698 | Brittni Throgmorton | Social Worker | 378 Williamson Rd Ste 207, Mooresville, NC 28117-5917 | 2020-08-18 |
| 1386267581 | Linda Ann Costa-daniello | Social Worker | 120 Riding Trail, Mooresville, NC 28117-9165 | 2020-05-21 |
| 1629698782 | Lynn B Puma | Social Worker | 158 Clover Bank Rd, Mooresville, NC 28115-7872 | 2020-04-19 |
| 1316509102 | Shirley Marie Curry | Social Worker | 174 Devon Forest Dr, Mooresville, NC 28115-7913 | 2019-07-02 |
| 1992281141 | Kristin M Mobley | Social Worker | 131 Nevis Ln, Mooresville, NC 28115-2811 | 2018-07-11 |
| 1245756295 | Lkn Counseling and Sex Therapy, Pllc. | Social Worker | 110 Charleston Dr Unit 109108, Mooresville, NC 28117-7700 | 2017-08-21 |
| 1801317383 | Jessie Watts Gogg | Social Worker | 138 Shepherd Rd, Mooresville, NC 28115 | 2017-07-05 |
| Find all providers in MOORESVILLE | ||||
| City | MOORESVILLE |
| Zip Code | 28117 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.