Provider Demographics
NPI:1316121460
Name:BEARWOOD, SHAWN E (LMHC, CDP)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:E
Last Name:BEARWOOD
Suffix:
Gender:F
Credentials:LMHC, CDP
Other - Prefix:
Other - First Name:SHAMORA
Other - Middle Name:
Other - Last Name:BEARWOOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 73
Mailing Address - Street 2:
Mailing Address - City:SILVANA
Mailing Address - State:WA
Mailing Address - Zip Code:98287
Mailing Address - Country:US
Mailing Address - Phone:360-333-8433
Mailing Address - Fax:
Practice Address - Street 1:16404 SMOKEY POINT BLVD STE 208
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8417
Practice Address - Country:US
Practice Address - Phone:360-708-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60227285101YM0800X
WARC00041996101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC00041996OtherREGISTERED COUNSELOR