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General NPI Number Information
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NPI Number | 1528952959
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Entity Type | Individual
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Provider Name | SHANA LOUISE ELISE WILLENBRING LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 100 N FRANKLIN ST UNIT 9
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City | MANCHESTER
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State | IA
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Zip | 52057-1541
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Country | US
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Telephone | 319-435-1819
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N FRANKLIN ST UNIT 9
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City | MANCHESTER
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State | IA
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Zip | 52057-1541
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Country | US
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Telephone | 319-435-1819
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 361651
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 06049
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License Number State | IA
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