MEDICARE: SHAUNA MICHAELS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1033535190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAUNA MICHAELS LCSW

Provider Business Mailing Address
First Line	:	2860 NATIVE OAK DR
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-7198
Country	:	US
Telephone Number	:	530-513-9408
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 ILAHEE LN STE 100
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95973-7205
Country	:	US
Telephone Number	:	530-514-9408
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2014
Last Update Date	:	10/22/2019

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