Individual
SHELLANY JEAN CUSHNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1600 S MAIN ST, LEBANON, OR 97355-3109
(541) 967-3866
Mailing address
SANTIAM HWY, LEBANON, OR 97355-9511
(541) 967-3866
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
L7698
OR
1041C0700X
Clinical Social Worker
Primary
L7698
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
$$$$$$$$$
—
OR
Enumeration date
10/10/2018
Last updated
12/20/2018
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