Individual provider · Type 1 NPI

Shaliah Deaisja Monteia Wilson

Addiction (Substance Use Disorder) Counselor · Myrtle Beach, SC

NPI number 1902755671 Active

Practice location

104 George Bishop Pkwy
Myrtle Beach, SC 29579-7335

Call (866) 850-6585 Map

Mailing address

7218 Broomstraw Ct
Nichols, SC 29581-6208

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1902755671

Shaliah Deaisja Monteia Wilson's National Provider Identifier is 1902755671, issued on Jan 26, 2026. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Myrtle Beach, SC. The record was last updated on Jan 26, 2026.