MR. DANIEL WATKINS SHATTUCK (NPI# 1558315820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558315820 |
| Entity Type | Individual |
| Full Name | MR. DANIEL WATKINS SHATTUCK |
| Credential | PH.D.,LPC |
| Practice Address |
4505 Fair Meadows Ln Suite 206 Raleigh NC 27607-6465 |
| Practice Telephone | 9193599700 |
| Practice Fax Number | 9193599705 |
| Mailing Telephone | 9193599700 |
| Mailing Fax Number | 9193599705 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2013-06-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
3398 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BLUE CROSS AND BLUE SHIEL | 75888 | 01 |
| NC | 6102454 | 05 | |
| NC | MEDCOST PREFERRED | E0478 | 01 |
| Street Address |
4505 FAIR MEADOWS LN SUITE 206 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-6465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386636702 | Gail Loretta Lieblang | Nurse Practitioner | 4505 Fair Meadows Ln, Blue Ridge Plaza Suite 204 (unc Clinical Research ), Raleigh, NC 27607-6465 | 2005-08-22 |
| 1154953875 | Kristine Jeter | Nurse Practitioner | 4505 Fair Meadows Ln, Raleigh, NC 27607-6465 | 2020-02-11 |
| 1063937415 | Jill C Vanarthos | Physician Assistant | 4505 Fair Meadows Ln, Raleigh, NC 27607-6465 | 2017-08-07 |
| 1689107039 | Wendy Krull | Social Worker | 4505 Fair Meadows Ln, Raleigh, NC 27607-6465 | 2017-04-04 |
| 1891226858 | Best Day Psychiatry and Counseling, PC | Psychiatry & Neurology | 4505 Fair Meadows Ln, Suite 102, Raleigh, NC 27607-6465 | 2017-03-22 |
| 1558742692 | Monique Link | Psychologist | 4505 Fair Meadows Ln, Suite 106, Raleigh, NC 27607 | 2015-06-15 |
| 1205216181 | Psychological Services of Cindy C. Cottle, Pllc | Psychologist | 4505 Fair Meadows Ln, Ste 106, Raleigh, NC 27607-6465 | 2015-06-04 |
| 1790054500 | Deanna L Towns | Counselor | 4505 Fair Meadows Ln, Suite 211, Raleigh, NC 27607-6465 | 2011-12-22 |
| 1003024928 | Henry H Hancock IIi Dds Ms Pa | Dentist | 4505 Fair Meadows Ln, Suite 220, Raleigh, NC 27607-6465 | 2007-05-21 |
| 1801000252 | William George Bixler | Psychologist | 4505 Fair Meadows Ln, Suite 106, Raleigh, NC 27607-6465 | 2007-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007759 | James Carroll Pittman IIi | Counselor | 2301 Stonehenge Dr Ste 110, Raleigh, NC 27615-4379 | 2020-09-09 |
| 1043820715 | Keep Counsel | Counselor | 8320 Hardeth Way, Raleigh, NC 27616-3237 | 2020-08-06 |
| 1023647047 | Lets Cope Counseling Services Pllc | Counselor | 1631 Midtown Pl Ste 104-126, Raleigh, NC 27609-1300 | 2020-04-02 |
| 1841834785 | Vernetta J Davis | Counselor | 6604 Six Forks Rd Ste 101, Raleigh, NC 27615-6521 | 2019-11-04 |
| 1053955187 | Kelsie Ann Adkisson | Counselor | 5171 Glenwood Ave Ste 221, Raleigh, NC 27612-3266 | 2019-10-31 |
| 1841841012 | Galana Tennille Chookolingo | Counselor | 1123 Ileagnes Rd, Raleigh, NC 27603-2378 | 2019-09-27 |
| 1720639917 | Kelly Marie Nelson | Counselor | 205 Delway St Unit A, Raleigh, NC 27604-1131 | 2019-09-27 |
| 1720649890 | Maryann Kathryn Garcia | Counselor | 5805 Hampton Ridge Rd, Raleigh, NC 27603-9259 | 2019-06-27 |
| 1568929503 | Kelly Harrison Counseling Pllc | Counselor | 3200 Wake Forest Rd Ste 204, Raleigh, NC 27609-7451 | 2019-02-26 |
| 1639645278 | Donald G Wiggins | Counselor | 7516 Longstreet Dr, Raleigh, NC 27615-6131 | 2018-10-22 |
| Find all providers in RALEIGH | ||||
Please comment or provide details below to improve the information on MR. DANIEL WATKINS SHATTUCK.
| 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.