Mickenham, Shana

Mickenham, Shana is an individual health care provider with primary practice located at 508 Upland Drive , Kenai AK 99611. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Mickenham, Shana can be contacted via phone (907) 335-7500.

Contact Information

Primary practice address
508 Upland Drive Kenai AK 99611
Phone: (907) 335-7500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1972089738
LBN Legal business name Mickenham, Shana
Credentials MS, CDCS, BHP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2018
Last updated Jan 24th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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