Individual provider · Type 1 NPI

Shawnta' Tyrrell Tisdale

Counselor · Conway, SC

NPI number 1235162553 Active

Practice location

164 Waccamaw Medical Park Dr
Conway, SC 29526-8903

Call (843) 347-5060 Map

Mailing address

1184 Sumter Hwy
Kingstree, SC 29556-4951

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1235162553

Shawnta' Tyrrell Tisdale's National Provider Identifier is 1235162553, issued on Jul 9, 2006. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Conway, SC. The record was last updated on Jul 8, 2007.