Provider Demographics
NPI:1861542417
Name:SHULER, DEBRA BAILEY (LPC)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:BAILEY
Last Name:SHULER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11023 HARROWFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4480
Mailing Address - Country:US
Mailing Address - Phone:704-737-0790
Mailing Address - Fax:
Practice Address - Street 1:2200 E 7TH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3340
Practice Address - Country:US
Practice Address - Phone:704-376-7180
Practice Address - Fax:704-376-0904
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2010-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4683101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102729Medicaid