Shana Mickenham, LPC, CDCS, BHP
Individual provider Active NPI Mental Health Counselor · Kenai, AK
NPI 1972089738 · NPPES record last updated Apr 13, 2026
Key facts
- NPI
- 1972089738
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 508 Upland St
Kenai, AK 99611-8026 - Phone
- (907) 335-7500
- NPI assigned
- Jul 16, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Bellevue Hospital Medical College, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kenaitze Indian Tribe
Practice addresses (Care Compare)
508 Upland St
Kenai, AK 99611-8026
Phone (907) 335-7500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240514001286 | AK | Practitioner - Mental Health Counselor | 5193166767 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenaitze Indian Tribe | Current | Accepting new patients | |
| Kenaitze Indian Tribe | Current |
Accepting new patients | |
| Kenaitze Indian Tribe | Current |
Accepting new patients | |
| Kenaitze Indian Tribe | Past |
Accepting new patients | |
| Copper River Native Association | Past | Accepting new patients |
Locations
508 Upland St
Kenai, AK 99611
Phone (907) 335-7300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes | ||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X |
Addresses
Primary practice location
508 Upland St
Kenai, AK 99611-8026
Mailing address
PO Box 84101
Seattle, WA 98124-5401
Phone (907) 335-7500
Other practice location 1
206 W Rockwell Ave
Soldotna, AK 99669-7439
Phone (907) 335-7500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1716463 | Medicaid | AK | |
| 1757656 | Medicaid | AK |
Other providers in Kenai, AK
- Mark R Mencel
- Ann Marie Mercer
- Heidi Beth Metteer
- Mary Jo Mettler
- Karey Mewbourn
- Rhonda Lynn Miles
- Andrea L. Miller
- Linda Apollonia Miller
- Rachel Marie Minkel
- Alyssa J Minnich
All providers in Kenai, AK · Mental Health Counselor in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.