Provider Demographics
NPI:1962731968
Name:SHAY, GRETCHEN ANN (LCSW, CADC)
Entity type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:ANN
Last Name:SHAY
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:MRS
Other - First Name:GRETCHEN
Other - Middle Name:ANN
Other - Last Name:FEINHOLZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:100 ESSEX CT STE A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-3140
Mailing Address - Country:US
Mailing Address - Phone:256-325-2388
Mailing Address - Fax:256-325-2395
Practice Address - Street 1:100 ESSEX CT STE A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3140
Practice Address - Country:US
Practice Address - Phone:256-325-2388
Practice Address - Fax:256-325-2395
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-22
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0139081041C0700X
AL4865C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical