Provider Demographics
NPI:1467671115
Name:CALABRESE, SHANNON MICHELLE (LIMHP, LADC)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:MICHELLE
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:LIMHP, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 S 186TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-4153
Mailing Address - Country:US
Mailing Address - Phone:402-515-2546
Mailing Address - Fax:402-502-1282
Practice Address - Street 1:3201 N 170TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-2654
Practice Address - Country:US
Practice Address - Phone:402-515-2546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1580101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional