MRS. SHAVONNE RENEE RICHARDSON (NPI# 1275722555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275722555 |
| Entity Type | Individual |
| Full Name | MRS. SHAVONNE RENEE RICHARDSON |
| Credential | LPC |
| Practice Address |
900c Main St Suite B Conway SC 29526-4025 |
| Practice Telephone | 8434881877 |
| Practice Fax Number | 8434881887 |
| Mailing Telephone | 8434881877 |
| Mailing Fax Number | 8434881887 |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2016-09-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
900C MAIN ST SUITE B |
| City | CONWAY |
| State | SC |
| Zip Code | 29526-4025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
| 1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
| 1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
| 1598227431 | Surgery Center of Conway Inc | Clinic/Center | 1405 Main Street, Conway, SC 29526 | 2019-04-01 |
| 1801374962 | Trevor James Hess | Specialist/Technologist | 905 One Landon Loop, Conway, SC 29526 | 2018-08-01 |
| 1851800817 | Katherine Ann Nimphius | Behavioral Analyst | 105 Timberline Dr, Conway, SC 29526 | 2017-09-21 |
| 1922544253 | William Houck | Specialist/Technologist | 925 One Landon Loop, Conway, SC 29526 | 2017-01-10 |
| 1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
| 1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
| 1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
| Find all providers in zip 29526 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104442565 | Deandriea Bass-carrigan | Counselor | 1570 Rachel Dr, Conway, AR 72032-8619 | 2020-06-22 |
| 1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
| 1609244151 | Matthew Spicer | Counselor | 1051 Hogan Ln, Conway, AR 72034-9126 | 2015-09-14 |
| 1578968988 | Pshanda Chante Pugh | Counselor | 1208 Dunraven Ct, Conway, SC 29527-3170 | 2014-10-28 |
| 1013294560 | Susan Ann Mclean | Counselor | 172 Waccamaw Medical Park Ct, Conway, SC 29526-8965 | 2011-11-11 |
| 1730474560 | Pamela Hendrixson | Counselor | 2159 Prince St, Suite B, Conway, AR 72034-3737 | 2011-06-09 |
| 1174832174 | Latoya Bernice Gathers | Counselor | 1632 9th Ave, Conway, SC 29527-4848 | 2010-09-25 |
| 1700023876 | Scarlett Evert | Counselor | 575 Harkrider St, Conway, AR 72032-5631 | 2009-01-12 |
| 1972795458 | Jessica E Goodwin | Counselor | 164 Waccamaw Medical Park, Conway, SC 29526-8903 | 2007-08-17 |
| 1609085919 | Jonathan Michael Glass | Counselor | 204 University Blvd, Conway, SC 29526-8834 | 2007-05-22 |
| Find all providers in CONWAY | ||||
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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.