Individual
KATIE LYNN SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAT, LCPC, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CC6353
ME
101YP2500X
Professional Counselor
LPC.0016675
CO
221700000X
Art Therapist
Primary
002452
NY
Other
Enumeration date
11/11/2020
Last updated
02/13/2023
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