DR. SHANNON S DOUGHTY (NPI# 1700947751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700947751 |
| Entity Type | Individual |
| Full Name | DR. SHANNON S DOUGHTY |
| Credential | PHD, BCBA |
| Practice Address |
1902 Old Parsonage Rd Charleston SC 29414-6205 |
| Mailing Address |
Po Box 80901 Charleston SC 29416-0901 |
| Practice Telephone | 8432598853 |
| Mailing Telephone | 8432598853 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | WP8971 | 05 |
| Street Address |
1902 OLD PARSONAGE RD |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29414-6205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306174305 | Carolina Coast Behavioral Services, LLC | Community/Behavioral Health | 1902 Old Parsonage Rd, Charleston, SC 29414-6205 | 2009-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902444508 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 3865 West Ashley Circle, Charleston, SC 29414 | 2019-12-13 |
| 1215440169 | Christine Michelle Delcioppo | Nurse Practitioner | 2085 Henry Tecklenburg Dr Fl 2or2, Charleston, SC 29414 | 2017-11-14 |
| 1871013508 | Carolyn Sorenson | Assistant Behavior Analyst | 2218 Hunter Creek Dr, Charleston, SC 29414 | 2017-06-23 |
| 1205387354 | Rachel Klatt | Physical Therapist | 2230 Ashley Crossing Dr., Charleston, SC 29414 | 2016-10-24 |
| 1295286912 | Mary M Butler | Physical Therapy Assistant | 2230 Ashley Crossing Drive, Charleston, SC 29414 | 2016-10-18 |
| 1295104982 | Charlene Barbot | Registered Nurse | 3741 Clover St, Charleston, SC 29414 | 2015-09-23 |
| 1720467525 | Sasha M. Perez | Family Medicine | 3030 Ashley Town Center Dr Ste 102a, Charleston, SC 29414 | 2015-05-26 |
| 1104226240 | Angela Mcinvale | Counselor | 3030 Ashley Town Center Dr., Bldg. B-203, Charleston, SC 29414 | 2014-08-26 |
| 1659790087 | Catherine Jefferson Vanderwerker | Physical Therapist | 3019 Saintsbury Cove Dr, Charleston, SC 29414 | 2014-04-14 |
| 1104266741 | Elizabeth A Burguieres | Psychiatry & Neurology | Scdmh- Charleston Telepsychiatry Office, 706 Orleans Rd, Charleston, SC 29414 | 2013-06-27 |
| Find all providers in zip 29414 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437363330 | Joshua Gordon Chinitz | Psychologist | 1578 Dowden Ct, Charleston, SC 29407-5011 | 2007-05-09 |
| 1366726515 | Kirstin Gros | Psychologist | 109 Bee St, Ralph H Johnson Vamc, Mental Health Service Line 116, Charleston, SC 29401-5703 | 2011-10-06 |
| 1841525730 | Preferred Psychological Solutions, Pllc | Psychologist | 1116 Smith St, Suite 207, Charleston, WV 25301-1314 | 2009-10-09 |
| 1982819538 | Peter Tuerk | Psychologist | 109 Bee St., Charleston, SC 29401-5799 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750810214 | Jenice Ivette Green | Psychologist | 801 Oakwood St Apt 6g, Bennettsville, SC 29512-2465 | 2017-06-08 |
| 1770948457 | Lorraine Tavarez Lopez | Psychologist | 1 Windsor Cv Ste 404, Columbia, SC 29223-1833 | 2015-12-22 |
| 1265847255 | Tracy Redfearn Inc. | Psychologist | 702b W Carolina Ave, Hartsville, SC 29550-4412 | 2014-06-27 |
| 1356604466 | Brittany Moree Rudy | Psychologist | 127 W Antrim Dr, Greenville, SC 29607-2505 | 2012-06-22 |
| 1376847483 | Susan Kreh Beck | Psychologist | 304 Firebridge Rd, Columbia, SC 29223-5122 | 2011-01-04 |
| 1710215520 | James Reid | Psychologist | 670 Blvd De France, Parris Island, SC 29905 | 2009-12-07 |
| 1710212196 | Tabitha Delaina Ball | Psychologist | 1199 Chivalry St, Sumter, SC 29154-7412 | 2009-10-02 |
| 1346410446 | William Harrison Wells | Psychologist | 1665 Herlong Ct Ste B, Rock Hill, SC 29732-1193 | 2008-03-04 |
| 1164692497 | Michael Gene Dodson | Psychologist | 145 Veranda Lane, Aiken, SC 29803-4907 | 2008-03-03 |
| 1174740625 | David Silas Green | Psychologist | 1016 Vaucluse Road, Aiken, SC 29801 | 2007-04-19 |
| Find all providers with the same taxonomy | ||||
| City | CHARLESTON |
| Zip Code | 29414 |
Please comment or provide details below to improve the information on DR. SHANNON S DOUGHTY.
| 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.