Individual
BENROY SHIMOTANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
227 METRO DR, JEFFERSON CITY, MO 65109-1134
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2024003538
MO
101YP2500X
Professional Counselor
Primary
2026002955
MO
Other
Enumeration date
02/20/2024
Last updated
01/22/2026
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