Provider Demographics
NPI:1134373780
Name:CLAUSSEN, SHANON ANN (LISW)
Entity type:Individual
Prefix:
First Name:SHANON
Middle Name:ANN
Last Name:CLAUSSEN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577-3915
Mailing Address - Country:US
Mailing Address - Phone:319-350-6718
Mailing Address - Fax:
Practice Address - Street 1:1907 17TH AVE E
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-3554
Practice Address - Country:US
Practice Address - Phone:641-569-8098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA006911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical