Healthcare Provider Details

I. General information

NPI: 1780472779
Provider Name (Legal Business Name): SHAYNA ELIZABETH ALLOWAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 N BROADWAY ST STE B
GREEN SPRINGS OH
44836-9734
US

IV. Provider business mailing address

430 N BROADWAY ST STE B
GREEN SPRINGS OH
44836-9734
US

V. Phone/Fax

Practice location:
  • Phone: 419-307-9128
  • Fax:
Mailing address:
  • Phone: 419-307-9128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.192093
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: