Individual
MS. SHANNON ANDREWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9494 N GOVERNMENT WAY # 103, HAYDEN, ID 83835-9848
(208) 967-6895
(208) 277-0766
Mailing address
PO BOX 1575, POST FALLS, ID 83877-1575
(208) 967-6895
(208) 277-0766
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
LCSW-36039
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8139486-3501
UTAH LICENSE
UT
01
—
LCSW-36039
PROFESSIONAL STATE LICENSE
ID
Enumeration date
09/01/2016
Last updated
10/05/2023
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