Provider Demographics
NPI:1912345463
Name:EISCHEN, SHANNA L (MS, LPC, IMH-II)
Entity Type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:L
Last Name:EISCHEN
Suffix:
Gender:F
Credentials:MS, LPC, IMH-II
Other - Prefix:
Other - First Name:SHANNA
Other - Middle Name:
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:6308 E 15TH ST STE 2C
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-6411
Mailing Address - Country:US
Mailing Address - Phone:918-695-0996
Mailing Address - Fax:
Practice Address - Street 1:6308 E 15TH ST STE 2C
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-6411
Practice Address - Country:US
Practice Address - Phone:918-695-0996
Practice Address - Fax:918-699-0598
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor