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SHADYBROOK PSYCHOLOGICAL SERVICES PLLC
NPI 1225799257
Psychologist - Clinical in Clemmons, NC

Active since January 03, 2022
2554 LEWISVILLE CLEMMONS RD STE 304, CLEMMONS, NC 27012(636) 487-7654 Get Directions Write a Review

NPPES record last updated: June 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 17, 2024, Jan 3, 2022 (2 updates tracked since 2022).

About Shadybrook Psychological Services Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHADYBROOK PSYCHOLOGICAL SERVICES PLLC (NPI 1225799257) is a healthcare organization registered as a clinical in Clemmons, North Carolina and active in the NPI registry since January 2022. The organization lists Susanne Palmer, Owner/authorized Official, as its authorized official.

NPPES Registry Identity

NPI1225799257
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameSHADYBROOK PSYCHOLOGICAL SERVICES PLLC
Location Address2554 LEWISVILLE CLEMMONS RD STE 304Clemmons, NC 27012-8749
Mailing Address2554 Lewisville Clemmons Rd Ste 304Clemmons, NC 27012-8749
Phone(636) 487-7654
Organization SubpartNo
Authorized OfficialSusanne PalmerOwner/authorized Official · (336) 200-8808
Enumeration DateJanuary 3, 2022
Last NPPES UpdateJune 17, 20242 updates tracked since enumeration
NPPES CertifiedJune 17, 2024
✔ NPI 1225799257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2554 LEWISVILLE CLEMMONS RD STE 304, Clemmons, NC 27012
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY WEAVER MS, LCMHC
Counselor (Mental Health)
2554 LEWISVILLE CLEMMONS RD STE 304
CLEMMONS, NC 27012
Forsyth County (404) 721-5994

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shadybrook Psychological Services PLLC's NPI number?

The NPI number for Shadybrook Psychological Services PLLC is 1225799257. It was assigned to this organization in the NPPES registry on January 3, 2022.

Where is Shadybrook Psychological Services PLLC located?

Shadybrook Psychological Services PLLC is located at 2554 Lewisville Clemmons Rd Ste 304, Clemmons, NC 27012. The listed phone number is (636) 487-7654.

What is Shadybrook Psychological Services PLLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Shadybrook Psychological Services PLLC was last updated on June 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.