Provider Demographics
NPI:1528952959
Name:WILLENBRING, SHANA LOUISE ELISE (LMSW)
Entity type:Individual
Prefix:
First Name:SHANA
Middle Name:LOUISE ELISE
Last Name:WILLENBRING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SHANA
Other - Middle Name:LOUISE
Other - Last Name:BISCHOF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:100 N FRANKLIN ST UNIT 9
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-1541
Mailing Address - Country:US
Mailing Address - Phone:319-435-1819
Mailing Address - Fax:
Practice Address - Street 1:100 N FRANKLIN ST UNIT 9
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-1541
Practice Address - Country:US
Practice Address - Phone:319-435-1819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3616511041S0200X
IA06049104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool