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Shannon Dwayne Kretz, AA,CDPT
Counselor in Kelso, Washington
NPI 1861977936

Shannon Dwayne Kretz is a Counselor based in Longview, WA. Shannon Dwayne Kretz practices in Kelso, WA and has the professional credentials of AA,CDPT. The NPI Number for Shannon Dwayne Kretz is 1861977936 and holds a License No. 60871961 (Washington).

The current practice location address for Shannon Dwayne Kretz is 309 Oak St, Kelso, WA and can be reached out via phone at 360-423-0203 and via fax at 360-577-7904.

Location: 309 Oak St, Kelso, WA, 98632
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1861977936
Provider Name
Shannon Dwayne Kretz
Credential
AA,CDPT
Provider Entity Type
Individual
Gender
Male
Address
309 Oak St, Kelso, WA, 98632
Phone Number
360-423-0203
Fax Number
360-577-7904
Provider Enumeration Date
09/25/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2108137 05 WA
institution
Provider Business Practice Location Address Details
Address
309 Oak St
City
Kelso
State
Washington
Zip
98626-2340
Phone Number
360-423-0203
Fax Number
360-577-7904
person
Provider Business Mailing Address Details
Address
309 Oak St
City
Kelso
State
Washington
Zip
98626-2340
Phone Number
360-423-0203
Fax Number
360-577-7904
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
60871961 (Washington)
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's degree and clinical experience and supervision for licensure or certification.
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