Provider Demographics
NPI:1295292357
Name:DANZUKA, SHELIA MARIE (LCSW, MSW, MA, MFT)
Entity type:Individual
Prefix:MRS
First Name:SHELIA
Middle Name:MARIE
Last Name:DANZUKA
Suffix:
Gender:
Credentials:LCSW, MSW, MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 SW GLACIER PL
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-7626
Mailing Address - Country:US
Mailing Address - Phone:503-949-4119
Mailing Address - Fax:541-244-1303
Practice Address - Street 1:2326 SW GLACIER PL
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-7626
Practice Address - Country:US
Practice Address - Phone:503-949-4119
Practice Address - Fax:541-244-1303
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 106H00000X
ORL161021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist