Provider Demographics
NPI:1346913449
Name:WOLFORD, SHANAI ANN (QMHA, CADC-R)
Entity type:Individual
Prefix:
First Name:SHANAI
Middle Name:ANN
Last Name:WOLFORD
Suffix:
Gender:F
Credentials:QMHA, CADC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 PEARL ST STE 101
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3570
Mailing Address - Country:US
Mailing Address - Phone:541-799-5386
Mailing Address - Fax:
Practice Address - Street 1:508 W AGEE ST
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-2515
Practice Address - Country:US
Practice Address - Phone:541-799-5386
Practice Address - Fax:541-588-1150
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)