Provider Demographics
NPI:1851765051
Name:COLLAZO-CORDONES, SHAINA MARIE (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:SHAINA
Middle Name:MARIE
Last Name:COLLAZO-CORDONES
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 N FINDLAY ST FL 1
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2302
Mailing Address - Country:US
Mailing Address - Phone:717-434-2098
Mailing Address - Fax:
Practice Address - Street 1:45 N FINDLAY ST FL 1
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2302
Practice Address - Country:US
Practice Address - Phone:717-434-2098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-25
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132302104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker