Provider Demographics
NPI:1477043602
Name:METCALF, SHAYLENE S
Entity type:Individual
Prefix:
First Name:SHAYLENE
Middle Name:S
Last Name:METCALF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8623 E 32ND ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-3317
Mailing Address - Country:US
Mailing Address - Phone:316-869-2888
Mailing Address - Fax:
Practice Address - Street 1:8623 E 32ND ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-3317
Practice Address - Country:US
Practice Address - Phone:316-869-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2022-09-27
Deactivation Date:2022-06-14
Deactivation Code:
Reactivation Date:2022-09-16
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No172V00000XOther Service ProvidersCommunity Health Worker