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Individual

SHANNON PAUL ROBINSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC,LCSW

Contact information

Practice address
2925 MONDOVI RD, EAU CLAIRE, WI 54701-6141
(715) 832-0238
(715) 832-0771
Mailing address
2925 MONDOVI RD, EAU CLAIRE, WI 54701-6141
(715) 832-0238
(715) 832-0238

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2144-125
WI
1041C0700X
Clinical Social Worker
3283-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2144-125
STATE LPC LICENSE #
WI
01
3283-123
STATE LCSW LICENSE #
WI
05
39670500
WI
01
39738
SECURITY HEALTH PLAN ID#
WI
Enumeration date
11/15/2006
Last updated
09/24/2008
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