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Individual

SHANNON JEAN MAXWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D, LP

Contact information

Practice address
115 N 7TH ST STE 6, SPEARFISH, SD 57783-2710
(605) 645-0100
(605) 717-1009
Mailing address
115 N 7TH ST STE 6, SPEARFISH, SD 57783-2710
(605) 645-0100
(605) 717-1009

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
530
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2009373
SD
Enumeration date
02/16/2012
Last updated
01/20/2026
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