Shenea Wallin
Individual provider Active NPI Social Worker · Eubank, KY
NPI 1174070643 · NPPES record last updated Sep 1, 2016
Key facts
- NPI
- 1174070643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 3110 Old Bull Rd
Eubank, KY 42567-7773 - Phone
- (606) 492-7661
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
3110 Old Bull Rd
Eubank, KY 42567-7773
Mailing address
PO Box 4047
West Somerset, KY 42564-4047
Phone (606) 492-7661
Other providers in Eubank, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.