Provider Demographics
NPI:1750252482
Name:SHELMADINE, LOGAN KATHERINE
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:KATHERINE
Last Name:SHELMADINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 HEALTH SERVICES RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NC
Mailing Address - Zip Code:28675-3000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:255 NORTHWEST LN
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28693-9244
Practice Address - Country:US
Practice Address - Phone:828-303-2938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCU20837106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist