Provider Demographics
NPI:1336103381
Name:CHECHOVSKY, SHANNA JAYNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:JAYNE
Last Name:CHECHOVSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:SHANNA
Other - Middle Name:J
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:11801 GREENWICK DR
Mailing Address - Street 2:11801 GREENWICK DR.
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-3206
Mailing Address - Country:US
Mailing Address - Phone:405-823-4543
Mailing Address - Fax:
Practice Address - Street 1:2200 NW 50TH ST
Practice Address - Street 2:SUITE 107E
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8044
Practice Address - Country:US
Practice Address - Phone:405-823-4543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical