Dejongh, Shelley L

Dejongh, Shelley L is an individual health care provider with primary practice located at 2925 Mondovi Rd , Eau Claire WI 54701-6141. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Dejongh, Shelley L can be contacted via phone (715) 832-0238.

Contact Information

Primary practice address
2925 Mondovi Rd Eau Claire WI 54701-6141
Phone: (715) 832-0238
Fax: (715) 832-0771
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Professional 101YP2500X 4160-125 Wisconsin

Profile Details

NPI number 1639232655
LBN Legal business name Dejongh, Shelley L
Credentials MS, LPC, CSAC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2006
Last updated May 11th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639232655 NPPES
Wisconsin MEDICAID 39170000

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