Individual
SHAWN THOMAS BENNINGFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
9702 STONESTREET RD STE 120, LOUISVILLE, KY 40272
(502) 749-6249
Mailing address
9702 STONESTREET RD STE 120, LOUISVILLE, KY 40272-6812
(502) 749-6249
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
165330
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100527100
—
KY
Enumeration date
08/30/2012
Last updated
06/06/2018
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