Provider Demographics
NPI:1124474879
Name:PAUSLEY, SHANTEL DIANN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:SHANTEL
Middle Name:DIANN
Last Name:PAUSLEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 134
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-0134
Mailing Address - Country:US
Mailing Address - Phone:712-363-2358
Mailing Address - Fax:
Practice Address - Street 1:1212 18TH ST STE B
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-1033
Practice Address - Country:US
Practice Address - Phone:712-363-2358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA079344101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health