Provider Demographics
NPI:1902570674
Name:QUIGLEY, SHAYNA MICHAEL (LMLP)
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:MICHAEL
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:LMLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SOUTHWIND PL STE 201
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-3186
Mailing Address - Country:US
Mailing Address - Phone:785-323-8632
Mailing Address - Fax:
Practice Address - Street 1:200 SOUTHWIND PL STE 201
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-3186
Practice Address - Country:US
Practice Address - Phone:785-233-0516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN101YM0800X
KS03149103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health