Individual
TAMMY SHANAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
229 W WALNUT ST, MAYFIELD, KY 42066-2223
(270) 251-3666
(270) 251-3506
Mailing address
229 W WALNUT ST, PO BOX 484, MAYFIELD, KY 42066-2223
(270) 251-3666
(270) 251-3506
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1775
KY
1041C0700X
Clinical Social Worker
1775
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82000613
—
KY
Enumeration date
06/21/2006
Last updated
08/10/2011
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