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SHANNON DWAYNE KRETZ AA, CDPT
NPI 1861977936
Counselor in Kelso, WA

Active since September 25, 2018
309 OAK ST, KELSO, WA 98626(360) 423-0203(360) 577-7904 Get Directions Write a Review

NPPES record last updated: February 5, 2019. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Feb 5, 2019, Sep 25, 2018 (2 updates tracked since 2018).

About Shannon Dwayne Kretz Aa, Cdpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON DWAYNE KRETZ AA, CDPT (NPI 1861977936) is an individual counselor in Kelso, Washington, licensed in Washington (60871961) and active in the NPI registry since September 2018.

NPPES Registry Identity

NPI1861977936
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameSHANNON DWAYNE KRETZCredential: AA, CDPT
Location Address309 OAK STKelso, WA 98626-2340
Mailing Address921 14th AvenueLongview, WA 98632 · (360) 423-0203 · Fax (360) 577-0269
Phone(360) 423-0203
Fax(360) 577-7904
Sole ProprietorNo
Enumeration DateSeptember 25, 2018
Last NPPES UpdateFebruary 5, 20192 updates tracked since enumeration
✔ NPI 1861977936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in WA · 60871961
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.
309 OAK ST, Kelso, WA 98626
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Other Names 1

Other Name (5)Shannon Dwayne Benjamin

Other Identifiers 1

Medicaid2108137WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Kaiser Permanente.Insurance ›

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

C & R EXECUTIVES, LLC
Counselor (Addiction (Substance Use Disorder))
309 OAK ST
KELSO, WA 98626
Cowlitz County (360) 577-7442
MR. PAUL ALLEN WELK AS,CDP
Counselor (Addiction (Substance Use Disorder))
309 OAK ST
KELSO, WA 98626
Cowlitz County (360) 577-7442
MARY KATHLEEN SULLIVAN M.A.
Counselor (Mental Health)
309 OAK ST
KELSO, WA 98626
Cowlitz County (360) 577-7442

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Kretz's NPI number?

The NPI number for Shannon Kretz is 1861977936. It was assigned to this individual provider in the NPPES registry on September 25, 2018. The provider is also known as Shannon Dwayne Benjamin.

Where is Shannon Kretz located?

Shannon Kretz practices at 309 Oak St, Kelso, WA 98626. The listed phone number is (360) 423-0203.

What is Shannon Kretz's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

What insurance does Shannon Kretz accept?

Health plans from Kaiser Permanente list Shannon Kretz as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shannon Kretz was last updated on February 5, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.