Provider Demographics
NPI:1225544661
Name:DUPREZ, SHENA A (LPC)
Entity Type:Individual
Prefix:
First Name:SHENA
Middle Name:A
Last Name:DUPREZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SHENA
Other - Middle Name:A
Other - Last Name:DUPREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SHENA GRASSMYER
Mailing Address - Street 1:PO BOX 319
Mailing Address - Street 2:
Mailing Address - City:BIGLER
Mailing Address - State:PA
Mailing Address - Zip Code:16825-0319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:122 53 BOULEVARD
Practice Address - Street 2:
Practice Address - City:COALPORT
Practice Address - State:PA
Practice Address - Zip Code:16627
Practice Address - Country:US
Practice Address - Phone:814-672-5881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010127101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional