Individual
MS. DEBORAH SUE SHADDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LMHP
Contact information
Practice address
102 OLIVE ST, LANSING, KS 66043-1639
(913) 651-2674
(866) 565-4853
Mailing address
520 SANTA FE ST, LEAVENWORTH, KS 66048-4444
(913) 651-2674
(866) 565-4853
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
358
KS
101YM0800X
Mental Health Counselor
550 & 378
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47082363726
—
NE
Enumeration date
02/08/2007
Last updated
06/14/2010
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