Individual
SHANA JULIET KELLEY-COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
151 N TEMPLE ST, LEWISTON, ME 04240-3350
(207) 212-6752
Mailing address
151 N TEMPLE ST, LEWISTON, ME 04240-3350
(207) 212-6752
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LC8266
ME
1041C0700X
Clinical Social Worker
Primary
LC8266
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270610099
—
ME
Enumeration date
08/31/2006
Last updated
03/07/2011
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