Provider Demographics
NPI:1912795881
Name:CARR, SHALON
Entity type:Individual
Prefix:
First Name:SHALON
Middle Name:
Last Name:CARR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140641
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-0641
Mailing Address - Country:US
Mailing Address - Phone:419-262-2368
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 140641
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-0641
Practice Address - Country:US
Practice Address - Phone:419-262-2368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172A00000XOther Service ProvidersDriver
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health