Provider Demographics
NPI:1225836323
Name:PATACSIL, SHANIA MONIQUE (SWLC)
Entity type:Individual
Prefix:
First Name:SHANIA
Middle Name:MONIQUE
Last Name:PATACSIL
Suffix:
Gender:
Credentials:SWLC
Other - Prefix:
Other - First Name:SHANIA
Other - Middle Name:MONIQUE
Other - Last Name:PATACSIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SHANIA PATACSIL SWLC
Mailing Address - Street 1:803 11TH AVE E
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-3142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:803 11TH AVE E
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-3142
Practice Address - Country:US
Practice Address - Phone:406-390-5281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-787961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical