Provider Demographics
NPI:1366330532
Name:SALTER, SHANNON (LCMHC-A)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:SALTER
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 SALTER LN
Mailing Address - Street 2:
Mailing Address - City:HAVELOCK
Mailing Address - State:NC
Mailing Address - Zip Code:28532-8727
Mailing Address - Country:US
Mailing Address - Phone:252-671-5187
Mailing Address - Fax:
Practice Address - Street 1:3537 MARTIN LUTHER KING JR BLVD # 215
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2209
Practice Address - Country:US
Practice Address - Phone:252-505-8150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21518101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor