Provider Demographics
NPI:1649069253
Name:NEUFELD, SHANNON (MACP, PLLC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:NEUFELD
Suffix:
Gender:
Credentials:MACP, PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 B ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3618
Mailing Address - Country:US
Mailing Address - Phone:360-966-1206
Mailing Address - Fax:
Practice Address - Street 1:2226 B ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3618
Practice Address - Country:US
Practice Address - Phone:360-966-1206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61671564101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health