Individual
SHANNON T MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
105 LYNDON LN STE 102, LOUISVILLE, KY 40222-5550
(502) 509-3178
Mailing address
105 LYNDON LN STE 102, LOUISVILLE, KY 40222-5550
(502) 509-3178
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
270659
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
270659
KENTUCKY LPCC LICENSE NUMBER
KY
Enumeration date
01/25/2021
Last updated
04/05/2022
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