Provider Demographics
NPI:1841442647
Name:STANIFER, SHIRLEY B (LPC)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:B
Last Name:STANIFER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-7047
Mailing Address - Country:US
Mailing Address - Phone:615-247-8249
Mailing Address - Fax:615-247-8249
Practice Address - Street 1:132 CENTRE ST
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-7047
Practice Address - Country:US
Practice Address - Phone:615-247-8249
Practice Address - Fax:615-247-8249
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN434101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional