Individual
KARIN SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
16941 N EAGLE RIVER LOOP RD, EAGLE RIVER, AK 99577-7824
(907) 406-7707
(907) 931-7248
Mailing address
19332 WAR ADMIRAL RD, EAGLE RIVER, AK 99577-8482
(417) 793-2396
(907) 931-7248
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
196321
AK
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/18/2020
Last updated
04/04/2024
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