Individual
SHANNA KATE WHITTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW, LICDC
Contact information
Practice address
1000 S FORT THOMAS AVE, FORT THOMAS, KY 41075-2305
(513) 226-8836
Mailing address
1000 S FORT THOMAS AVE, FORT THOMAS, KY 41075-2305
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ICDC.131129
OH
1041C0700X
Clinical Social Worker
I.1201495
OH
Other
Enumeration date
09/17/2013
Last updated
09/17/2013
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