Provider Demographics
NPI:1174767560
Name:SHEALEY, SUSAN OSBON (LPC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:OSBON
Last Name:SHEALEY
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 1:3030 ASHLEY TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5664
Mailing Address - Country:US
Mailing Address - Phone:843-735-5900
Mailing Address - Fax:843-735-7323
Practice Address - Street 1:3030 ASHLEY TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5664
Practice Address - Country:US
Practice Address - Phone:843-735-5900
Practice Address - Fax:843-735-7323
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5068101YP2500X
SC5285101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional