| Shadybrook Psychological Services Pllc | |
|
2554 Lewisville Clemmons Rd Ste 304 Clemmons NC 27012-8749 | |
| (636) 487-7654 | |
| Not Available |
| Full Name | Shadybrook Psychological Services Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2554 Lewisville Clemmons Rd Ste 304, Clemmons, North Carolina |
| Authorized Official Name and Position | Susanne Palmer (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3362008808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shadybrook Psychological Services Pllc 2554 Lewisville Clemmons Rd Ste 304 Clemmons NC 27012-8749 Ph: () - | Shadybrook Psychological Services Pllc 2554 Lewisville Clemmons Rd Ste 304 Clemmons NC 27012-8749 Ph: (636) 487-7654 |
| NPI Number | 1225799257 |
|---|---|
| Provider Enumeration Date | 01/03/2022 |
| Last Update Date | 06/17/2024 |
| Certification Date | 06/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225799257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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