Basic Information
| Provider Information | |||||||||
| NPI: | 1063932432 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHELTON | ||||||||
| FirstName: | CHRISTY | ||||||||
| MiddleName: | ROBINSON | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSWA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9160 FORUM CORPORATE PKWY STE 350 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339057808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662660555 | ||||||||
| FaxNumber: | 8662664999 | ||||||||
| Practice Location | |||||||||
| Address1: | 551 BREVARD RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288062316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282127021 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2017 | ||||||||
| LastUpdateDate: | 05/19/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | P011653 | NC | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | C012409 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.