Active NPI
Shawanna L. Holland
- Pastoral Counselor
- Chandler, AZ
National Provider Identifier
1679250104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- 09-91152
- Practice address
- 908 W Chandler Blvd # a
Chandler, AZ 85225-2548 - Phone
- (480) 899-0200
- Fax
- (480) 899-0202
- NPI assigned
- Jun 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 09-91152 | AZ | Primary |
Addresses
Primary practice location
908 W Chandler Blvd # a
Chandler, AZ 85225-2548
Mailing address
2901 W Angel Way
San Tan Valley, AZ 85144-6681
Phone (520) 213-1667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09-91152 | AZ | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687824000000",
"number": "1679250104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 W ANGEL WAY",
"city": "SAN TAN VALLEY",
"state": "AZ",
"postal_code": "851446681",
"telephone_number": "520-213-1667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "908 W CHANDLER BLVD # A",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852252548",
"telephone_number": "480-899-0200",
"fax_number": "480-899-0202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLAND",
"first_name": "SHAWANNA",
"middle_name": "L.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-27",
"last_updated": "2023-06-27",
"certification_date": "2023-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "AZ",
"license": "09-91152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.