Provider Demographics
NPI:1821481565
Name:RAGAN, SHAWNA L (LPC)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:L
Last Name:RAGAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W. 34TH AVE.
Mailing Address - Street 2:PMB 717
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503
Mailing Address - Country:US
Mailing Address - Phone:907-231-1243
Mailing Address - Fax:
Practice Address - Street 1:4400 BUSINESS PARK BLVD
Practice Address - Street 2:SUITE 11
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-7171
Practice Address - Country:US
Practice Address - Phone:907-231-1243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK893101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional