Provider Demographics
NPI:1558833665
Name:MASONBRINK, SHAUNA-LYN (LSW)
Entity type:Individual
Prefix:MS
First Name:SHAUNA-LYN
Middle Name:
Last Name:MASONBRINK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 MARSH RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-5823
Mailing Address - Country:US
Mailing Address - Phone:234-400-9647
Mailing Address - Fax:
Practice Address - Street 1:3625 MARSH RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-5823
Practice Address - Country:US
Practice Address - Phone:234-400-9647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0600168104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker