Provider Demographics
NPI:1902654684
Name:LODHOLZ, SHELBY LOUANN (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:LOUANN
Last Name:LODHOLZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4411 BLUE DEVILS WAY APT 5
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-3723
Mailing Address - Country:US
Mailing Address - Phone:573-513-2216
Mailing Address - Fax:
Practice Address - Street 1:4411 BLUE DEVILS WAY APT 5
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-3723
Practice Address - Country:US
Practice Address - Phone:573-513-2216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN325091041C0700X
MO20210338531041C0700X
MI68011139551041C0700X
MT702791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical