Provider Demographics
NPI:1386539963
Name:BELL AHMAD, SHANNA REAGAN (LMSW)
Entity type:Individual
Prefix:
First Name:SHANNA
Middle Name:REAGAN
Last Name:BELL AHMAD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9412 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2540
Mailing Address - Country:US
Mailing Address - Phone:316-209-5310
Mailing Address - Fax:316-613-0759
Practice Address - Street 1:9412 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2540
Practice Address - Country:US
Practice Address - Phone:316-209-5310
Practice Address - Fax:316-613-0759
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10804104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker