Provider Demographics
NPI:1215682802
Name:CRITES, SHANELLE (LPC-A)
Entity type:Individual
Prefix:
First Name:SHANELLE
Middle Name:
Last Name:CRITES
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:SHANELLE
Other - Middle Name:
Other - Last Name:CRITES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14759 LONGLEAF PNE
Mailing Address - Street 2:
Mailing Address - City:LA PINE
Mailing Address - State:OR
Mailing Address - Zip Code:97739-9436
Mailing Address - Country:US
Mailing Address - Phone:541-215-4477
Mailing Address - Fax:
Practice Address - Street 1:431 NW FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2878
Practice Address - Country:US
Practice Address - Phone:541-215-4477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-13
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR11452101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty