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Organization
SHANNON DEETS COUNSELING LLC
Active
Organization
SHANNON DEETS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON DEETS PH.D. (OWNER)
(814) 807-0487
Entity
Organization
Contact information
Practice address
898 PARK AVE, SUITE 16, MEADVILLE, PA 16335-3335
(814) 807-0487
Mailing address
898 PARK AVE, SUITE 16, MEADVILLE, PA 16335-3335
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC004908
PA
1041C0700X
Clinical Social Worker
CW003132L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024531890002
—
PA
01
—
1205938008
NPI
—
01
—
1912153289
NPI
—
Enumeration date
03/24/2014
Last updated
03/24/2014
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