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Individual
SHANNON M FLYNN
Active
Individual
SHANNON M FLYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
279884
LA
101YP2500X
Professional Counselor
Primary
180012013
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180012013
ILLINOIS LCPC LICENSE NUMBER
IL
Enumeration date
08/18/2011
Last updated
09/01/2021
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