Provider Demographics
NPI:1164666160
Name:SHANAHAN, GRETA A (LMHP, CPC)
Entity Type:Individual
Prefix:MRS
First Name:GRETA
Middle Name:A
Last Name:SHANAHAN
Suffix:
Gender:F
Credentials:LMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 S 29TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6056
Mailing Address - Country:US
Mailing Address - Phone:402-476-0104
Mailing Address - Fax:
Practice Address - Street 1:7100 S 29TH ST STE B
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6056
Practice Address - Country:US
Practice Address - Phone:402-476-0104
Practice Address - Fax:402-438-2801
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8844Q101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health