Provider Demographics
NPI:1164888434
Name:VEGA, SHAUNA (LSCSW)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:VEGA
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5933 SW 57TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66610-9459
Mailing Address - Country:US
Mailing Address - Phone:785-250-0056
Mailing Address - Fax:
Practice Address - Street 1:511 SW JACKSON ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603-3333
Practice Address - Country:US
Practice Address - Phone:785-232-1349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-02
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS51891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical