Shana Mickenham, LPC, CDCS, BHP | |
508 Upland St, Kenai, AK 99611-8026 | |
(907) 335-7500 | |
Not Available |
Full Name | Shana Mickenham |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 508 Upland St, Kenai, Alaska |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972089738 | NPI | - | NPPES |
1716463 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Entity Name | Kenaitze Indian Tribe |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932114600 PECOS PAC ID: 4082506225 Enrollment ID: O20040325000198 |
Mailing Address | Practice Location Address |
---|---|
Shana Mickenham, LPC, CDCS, BHP Po Box 988, Kenai, AK 99611 Ph: () - | Shana Mickenham, LPC, CDCS, BHP 508 Upland St, Kenai, AK 99611-8026 Ph: (907) 335-7500 |
Emily Anne Haakenson Remmer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 609 Marine Ave, Kenai, AK 99611 Phone: 907-398-0528 | |
Skyler Shay Diehl, Counselor Medicare: Not Enrolled in Medicare Practice Location: 508 Upland St, Kenai, AK 99611 Phone: 907-335-7500 | |
Miriam Alejandra Olivo, Counselor Medicare: Not Enrolled in Medicare Practice Location: 508 Upland St, Kenai, AK 99611 Phone: 907-335-7300 | |
Wendy Kay Dial, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10200 Kenai Spur Hwy, Kenai, AK 99611 Phone: 907-283-3658 Fax: 907-283-5046 | |
Linda May Perry, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 506 Lake St, Kenai, AK 99611 Phone: 907-283-7501 Fax: 907-283-9006 | |
Alecia Ann Gottlob, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 10200 Kenai Spur Hwy, Kenai, AK 99611 Phone: 907-283-3658 Fax: 907-283-5046 | |
Christine Bailey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 508 Upland St, Kenai, AK 99611 Phone: 907-335-7300 Fax: 888-491-3243 |