Individual
SHELLY HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
740 MCKINLEY AVE, KELLOGG, ID 83837-2693
(208) 783-0600
(208) 783-0192
Mailing address
202 E ANTON AVE, STE 206, COEUR D ALENE, ID 83815-3727
(208) 667-6095
(208) 667-6173
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW 26043
ID
1041C0700X
Clinical Social Worker
Primary
LMSW-39893
ID
Other
Enumeration date
07/01/2008
Last updated
01/14/2026
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