Provider Demographics
NPI:1528620440
Name:DRAYTON, SHAQUORA IMANI-CHANEL (LCMHC,LPC)
Entity type:Individual
Prefix:
First Name:SHAQUORA
Middle Name:IMANI-CHANEL
Last Name:DRAYTON
Suffix:
Gender:F
Credentials:LCMHC,LPC
Other - Prefix:
Other - First Name:SHAQUORA
Other - Middle Name:
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:549 HAWLEY ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-4155
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:549 HAWLEY ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-4155
Practice Address - Country:US
Practice Address - Phone:704-517-5407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17665101YM0800X
101YM0800X
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty