Provider Demographics
NPI:1851604219
Name:HOCHSTETLER, SHAWNDA LYN (MSED, PCC-S)
Entity Type:Individual
Prefix:MS
First Name:SHAWNDA
Middle Name:LYN
Last Name:HOCHSTETLER
Suffix:
Gender:F
Credentials:MSED, PCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6156
Mailing Address - Country:US
Mailing Address - Phone:330-399-1221
Mailing Address - Fax:330-399-1205
Practice Address - Street 1:2000 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6156
Practice Address - Country:US
Practice Address - Phone:330-399-1221
Practice Address - Fax:330-399-1205
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0700079-S101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2268719 (FACILTIY)Medicaid