Provider Demographics
NPI:1588890826
Name:MCTEAGUE POSPISHIL, SHANNON
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:MCTEAGUE POSPISHIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:MCTEAGUE
Other - Last Name:POSPISHIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 1/2 WALL ST
Mailing Address - Street 2:SUITE II
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2724
Mailing Address - Country:US
Mailing Address - Phone:828-337-0037
Mailing Address - Fax:
Practice Address - Street 1:20 HARRISON HILL RD
Practice Address - Street 2:
Practice Address - City:SWANNANOA
Practice Address - State:NC
Practice Address - Zip Code:28778-2202
Practice Address - Country:US
Practice Address - Phone:828-337-0037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional