| Doctor Name: | MS. SHENANDOAH CARDWELL |
| NPI Number: | 1710098611 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, NCC, LCPC |
| License Number: | NCC CERT # 22818 |
| Business Practice Address: | 34930 N Us Highway 45 Suite 101 Lake Villa, IL - 600467537 |
| Business Phone Number: | 8475437755 |
| Business Fax Number: | 8475437759 |
| Mailing Address: | 34930 N Us Highway 45, Suite 101 LAKE VILLA |
| State: | IL |
| Postal Code: | 600467537 |
| Phone Number: | 8475437755 |
| Fax Number: | 8475437759 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | NCC CERT # 22818 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |