Individual
SHANTY ROBBENNOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, CAADC, CCS
Contact information
Practice address
526 S CREYTS RD STE C, LANSING, MI 48917-8263
(517) 221-9522
Mailing address
526 S CREYTS RD STE C, LANSING, MI 48917-8263
(517) 221-9522
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-02650
MI
101YM0800X
Mental Health Counselor
Primary
6401012596
MI
101YP2500X
Professional Counselor
6401012596
MI
Other
Enumeration date
04/22/2013
Last updated
01/12/2024
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