Provider Demographics
NPI:1558033779
Name:PISCIOTTI, SHAWNA ANN (LMSW, CSW-INTERN)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:ANN
Last Name:PISCIOTTI
Suffix:
Gender:F
Credentials:LMSW, CSW-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 LONG VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89460-8221
Mailing Address - Country:US
Mailing Address - Phone:775-790-1991
Mailing Address - Fax:
Practice Address - Street 1:1281 TERMINAL WAY STE 110
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3246
Practice Address - Country:US
Practice Address - Phone:775-682-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7630-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical