Provider Demographics
NPI:1437559655
Name:PETERS, SHAWNA (LPC)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17598 W BLUE SKY DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85387-1223
Mailing Address - Country:US
Mailing Address - Phone:805-407-5709
Mailing Address - Fax:602-742-2770
Practice Address - Street 1:17598 W BLUE SKY DR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85387-1223
Practice Address - Country:US
Practice Address - Phone:805-407-5709
Practice Address - Fax:602-742-2770
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AZLPC-17566101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health