Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shavannah Te'Hera Wilson

Individual provider Mental Health Counselor · NPI 1295307098

Shavannah Te'Hera Wilson is a Mental Health Counselor in Long Beach, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021
Specialties on file
2

Practice location Address checks out

5150 E Pacific Coast Hwy Ste 100
Long Beach, CA 90804-3394
Phone: (562) 490-7600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 110321 (CA)
Mental Health Counselor Taxonomy 101YM0800X · Licence 110321 (CA)

Record details

NPI number1295307098
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 12, 2021
Last updated in NPPESJune 23, 2023
Certification dateJune 23, 2023

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