Provider Demographics
NPI:1306509740
Name:FLANNER, SHEENA
Entity type:Individual
Prefix:MRS
First Name:SHEENA
Middle Name:
Last Name:FLANNER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHEENA
Other - Middle Name:
Other - Last Name:MCGLOTHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2677 STEELSBURG HWY STE 10
Mailing Address - Street 2:
Mailing Address - City:CEDAR BLUFF
Mailing Address - State:VA
Mailing Address - Zip Code:24609-7056
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2677 STEELSBURG HWY STE 10
Practice Address - Street 2:
Practice Address - City:CEDAR BLUFF
Practice Address - State:VA
Practice Address - Zip Code:24609-7056
Practice Address - Country:US
Practice Address - Phone:276-701-2352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA541108079101Y00000X
VA0701011330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NOOtherNO