Provider Demographics
NPI:1124854468
Name:TOWNSEND, SHENEESE RENEE (CPC-I)
Entity type:Individual
Prefix:
First Name:SHENEESE
Middle Name:RENEE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:CPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4160 AKIRA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-4712
Mailing Address - Country:US
Mailing Address - Phone:702-743-0600
Mailing Address - Fax:
Practice Address - Street 1:8215 S EASTERN AVE STE 109
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2515
Practice Address - Country:US
Practice Address - Phone:725-213-1103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NVCI5494101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional