Provider Demographics
NPI:1861882649
Name:PERRY, SHAMELYA ENGLAND (MS, LCAS, MAC, SAP)
Entity type:Individual
Prefix:
First Name:SHAMELYA
Middle Name:ENGLAND
Last Name:PERRY
Suffix:
Gender:F
Credentials:MS, LCAS, MAC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 BEACH POINTE AVE APT 110
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-8645
Mailing Address - Country:US
Mailing Address - Phone:252-864-5259
Mailing Address - Fax:
Practice Address - Street 1:1010 BEACH POINTE AVE APT 110
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-8645
Practice Address - Country:US
Practice Address - Phone:252-864-5259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20176101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)