Provider Demographics
NPI:1497308571
Name:CHUPEIN, SHAYNA (LCSW)
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:
Last Name:CHUPEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 AVENUE E NW
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1741
Mailing Address - Country:US
Mailing Address - Phone:406-491-7771
Mailing Address - Fax:
Practice Address - Street 1:941 AVENUE E NW
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-1741
Practice Address - Country:US
Practice Address - Phone:406-491-7771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33000898A1041C0700X
MTBBH-SWLC-LIC-386391041C0700X
MTBBH-LCSW-LIC-426831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical