Individual
MR. SHANNON LARRY SUMRALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
234 HIGHWAY 28 W, LAUREL, MS 39443-7845
(504) 224-7651
(601) 729-9002
Mailing address
861 SCR 3, TAYLORSVILLE, MS 39168-5066
(504) 648-7036
(601) 729-9002
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
19687
TX
101YP2500X
Professional Counselor
Primary
3109
LA
101YP2500X
Professional Counselor
3254
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175767601
—
TX
Enumeration date
11/16/2006
Last updated
04/11/2025
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