Individual provider · NPI-1

Shawna Roen, LCSW

Social Worker, Clinical · Bullhead City, AZ

NPI number1366092306
StatusActive
Last updated in NPPESJan 20, 2025

Details

NPI
1366092306
Entity type
Individual (NPI-1)
Name
Shawna Roen
Credential
LCSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 11, 2019
Certification date
Jan 9, 2025
Last updated
Jan 20, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical19112AZYes
101YM0800X Counselor, Mental HealthLCSW-19912–

Practice location

3640 Highway 95 Ste 120
Bullhead City, AZ 86442-4336

Phone 928-900-4748 · Fax 928-420-8950

Mailing address

1959 E Desert Dr
Fort Mohave, AZ 86426-8802

Phone 928-862-8689

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