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General NPI Number Information
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NPI Number | 1134632664
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Entity Type | Individual
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Provider Name | SHELLEY A. LAGANO LPC
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Gender | Female
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Dates
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Enumeration Date | 11/07/2017
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 700 LIBERTY LN
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City | WEST CARROLLTON
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State | OH
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Zip | 45449-2135
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Country | US
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Telephone | 937-247-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 445 E DUBLIN GRANVILLE RD
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City | WORTHINGTON
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State | OH
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Zip | 43085-3192
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Country | US
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Telephone | 614-844-3800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.1801019
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License Number State | OH
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