Provider Demographics
NPI:1982716510
Name:SCHENKEL, SHELAH J (MA, LPC, NCC, DCEP)
Entity Type:Individual
Prefix:MS
First Name:SHELAH
Middle Name:J
Last Name:SCHENKEL
Suffix:
Gender:F
Credentials:MA, LPC, NCC, DCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 S NATIONAL AVE
Mailing Address - Street 2:SUITE D-8
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-2937
Mailing Address - Country:US
Mailing Address - Phone:417-886-2944
Mailing Address - Fax:888-843-0629
Practice Address - Street 1:4650 S NATIONAL AVE
Practice Address - Street 2:SUITE D-8
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-2937
Practice Address - Country:US
Practice Address - Phone:417-886-2944
Practice Address - Fax:888-843-0629
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005038996101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2005038996Medicaid