Provider Demographics
NPI:1245693217
Name:BEARD, SHAWNA (LMHCA)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:394-5 BIG HANAFORD RD
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531
Mailing Address - Country:US
Mailing Address - Phone:360-259-5710
Mailing Address - Fax:
Practice Address - Street 1:394-5 BIG HANAFORD RD
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531
Practice Address - Country:US
Practice Address - Phone:360-259-5710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61488941101YM0800X
WA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health