Provider Demographics
NPI:1427524032
Name:ALLEN, SHAINA MORGAN (ED S, NCSP)
Entity type:Individual
Prefix:
First Name:SHAINA
Middle Name:MORGAN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:ED S, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16950 W HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CASTLEWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:24224-7018
Mailing Address - Country:US
Mailing Address - Phone:276-698-0921
Mailing Address - Fax:
Practice Address - Street 1:628 LAKE ST NE
Practice Address - Street 2:
Practice Address - City:WISE
Practice Address - State:VA
Practice Address - Zip Code:24293-7919
Practice Address - Country:US
Practice Address - Phone:276-328-6113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0813000845Medicaid