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Individual
MICHAEL R SHANAHAN
Active
Individual
MICHAEL R SHANAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.DIV/LMFT
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
1279
MN
106H00000X
Marriage & Family Therapist
Primary
1379
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171987
UCARE
MN
05
—
407950700
—
MN
01
—
601120738
MAGELLAN
MA
01
—
70010000LF0190
BCBS
MA
01
—
820S5SH
BCBS
MN
Enumeration date
11/10/2005
Last updated
03/27/2024
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