SHANA MICKENHAM LPC CDCS BHP NPI 1972089738

NPI Information

  • NPI: 1972089738
  • Provider Name: SHANA MICKENHAM, LPC, CDCS, BHP
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 508 UPLAND ST
    KENAI, AK
    ZIP 99611
  • Phone: (907) 335-7500

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NPI Details

Shana Mickenham, LPC, CDCS, BHP is a mental health counselor in Kenai, AK with 9 years of experience. Shana Mickenham, LPC, CDCS, BHP NPI is 1972089738. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: BELLEVUE HOSPITAL MEDICAL COLLEGE
Graduation Year:2017

The provider's business location address is:

508 UPLAND ST
KENAI, AK
ZIP 99611-026
Phone: (907) 335-7500

The NPI 1972089738 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 7/16/2018 and was last updated on 8/12/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2101YM0800XCounselorMental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11716463MEDICAIDALASKA
21757656MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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