SHANNAN D HEADRICK (NPI# 1881235448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881235448 |
| Entity Type | Individual |
| Full Name | SHANNAN D HEADRICK |
| Practice Address |
121 Nw Chehalis Ave Chehalis WA 98532-2010 |
| Mailing Address |
Po Box 1371 Chehalis WA 98532-0340 |
| Practice Telephone | 3607409767 |
| Practice Fax Number | 3607405484 |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2019-10-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CO60904459 | WA | Behavioral Health & Social Service Providers |
| Street Address |
121 NW CHEHALIS AVE |
| City | CHEHALIS |
| State | WA |
| Zip Code | 98532-2010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396273637 | Misty Anne Glenn | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532 | 2017-05-31 |
| 1992345367 | Eva Delamater | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532-2010 | 2020-01-13 |
| 1558925313 | James Kyle Pratt | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532-2010 | 2019-04-26 |
| 1720561806 | Penny Kathleen Long | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532-2010 | 2018-09-13 |
| 1548743610 | Alexis C.l. Thurber | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532-2010 | 2018-09-13 |
| 1942718606 | Kathryn Allen | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532-2010 | 2018-01-16 |
| 1972025658 | Erin Renea West | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532-2010 | 2017-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275140832 | Joshua Russell Wachter | Registered Nurse | 275 W. Vine St., Napavine, WA 98532 | 2020-09-28 |
| 1891339123 | Dara Casey | Technician | 271-1 Romerman Rd, Chehalis, WA 98532 | 2019-10-30 |
| 1265997704 | April D Bacongco | Counselor | 500 Se Washington St, Chehalis, WA 98532 | 2019-02-08 |
| 1235610155 | Alyssa Dawn Ware | Physical Therapist | 1441 Kresky Ave, Chehalis, WA 98532 | 2018-08-28 |
| 1609365238 | American Behavioral Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 500 Se Adams Ave, Chehalis, WA 98532 | 2018-05-09 |
| 1043709314 | Kevin Bumatay Duran | Family Medicine | 931 S. Market Blvd, Chehalis, WA 98532 | 2018-05-02 |
| 1164922324 | William I. Mcmillan | Counselor | 121 Nw Chehalis St., Chehalis, WA 98532 | 2018-02-14 |
| 1285155366 | Great Rivers Behavioral Health Organization | Community/Behavioral Health | 57 W Main Street, Suite 260, Chehalis, WA 98532 | 2017-06-29 |
| 1841726221 | Dodi Forgione | Counselor | 2401 Ne Kresky Ave Ste D, Chehalis, WA 98532 | 2017-05-04 |
| 1780130625 | Dr.e.fletcher,llc | Dentist | 256 Northwest Park Street, Chehalis, WA 98532 | 2016-08-31 |
| Find all providers in zip 98532 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174095392 | Jennifer Lynn Canaan | Counselor | 505 Se Adams Ave, Chehalis, WA 98532-3031 | 2018-12-28 |
| 1457848970 | Sarah Louise Wolbert | Counselor | 151 Ne Hampe Way Ste C2-1, Chehalis, WA 98532-2403 | 2018-04-19 |
| 1164922324 | William I. Mcmillan | Counselor | 121 Nw Chehalis St., Chehalis, WA 98532 | 2018-02-14 |
| 1396273637 | Misty Anne Glenn | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532 | 2017-05-31 |
| 1689726499 | Inner Peace Counseling, Inc | Counselor | 118 N Market Blvd, Suite 1, Chehalis, WA 98532-2666 | 2007-01-18 |
| 1174137152 | Derik L Sandoval | Counselor | 500 Se Washington Ave, Chehalis, WA 98532-3058 | 2020-09-07 |
| 1477161552 | Jason Immanuel Brandis | Counselor | 1956 Ne Kresky Ave, Chehalis, WA 98532-2307 | 2020-07-15 |
| 1871113498 | Catrena D Taylor | Counselor | 151 N Market Blvd, Chehalis, WA 98532-2677 | 2020-04-23 |
| 1912534470 | Holly Ann Neill | Counselor | 1956 Ne Kresky Ave, Chehalis, WA 98532-2307 | 2020-03-25 |
| 1942840160 | Community Integrated Health Services, LLC | Counselor | 57 W Main St, Chehalis, WA 98532-4815 | 2020-01-15 |
| Find all providers in CHEHALIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.