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Individual

MS. CHRISTINE OTTAVIANO SHESTAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S. LMHC

Contact information

Practice address
109 N SCOTT ST, BLUFFTON, IN 46714-2004
(260) 824-0089
(260) 824-4209
Mailing address
PO BOX 205, BLUFFTON, IN 46714-0205
(260) 824-0089
(260) 824-4209

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000248A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000324156
ANTHEM BLUE CROSS
IN
05
200456370A
IN
01
345600
MANAGED HEALTH NETWORK
IN
01
473559000
MAGELLAN
IN
01
512125
VALUEOPTIONS
IN
Enumeration date
06/16/2005
Last updated
01/20/2012
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