Provider Demographics
NPI:1346587193
Name:SHELTON, SHAWNA M (MED, MS, LMHC)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:M
Last Name:SHELTON
Suffix:
Gender:F
Credentials:MED, MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 S SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1260
Mailing Address - Country:US
Mailing Address - Phone:509-455-8722
Mailing Address - Fax:
Practice Address - Street 1:845 S SHERMAN ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1260
Practice Address - Country:US
Practice Address - Phone:509-455-8722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2014-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60367869101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health