Individual provider · Type 1 NPI

Shasta Gabrielle Staten, MED, LPC

Professional Counselor · Charlotte, NC

NPI number 1124363718 Active

Practice location

5200 Park Rd Ste 218B
Charlotte, NC 28209-3650

Call (866) 700-1606 Map

Mailing address

12664 Persimmon Tree Dr
Charlotte, NC 28273-8024

Other practice locations

  • 12664 Persimmon Tree Dr, Charlotte, NC 28273-8024 · (704) 621-1095

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X9182 (NC)

Professional Counselor: Definition to come...

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About NPI 1124363718

Shasta Gabrielle Staten, MED, LPC's National Provider Identifier is 1124363718, issued on Dec 7, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Charlotte, NC. The record was last updated on Jun 23, 2021.