Provider Demographics
NPI:1649925017
Name:THEIS, SHAINA C (LCSW)
Entity type:Individual
Prefix:
First Name:SHAINA
Middle Name:C
Last Name:THEIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8027 MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-8003
Mailing Address - Country:US
Mailing Address - Phone:606-301-1374
Mailing Address - Fax:
Practice Address - Street 1:730 KENTON STATION RD
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-9619
Practice Address - Country:US
Practice Address - Phone:606-301-1374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2564821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical