Provider Demographics
NPI:1033475017
Name:SHRYOCK, GLYNNIS ANN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:GLYNNIS
Middle Name:ANN
Last Name:SHRYOCK
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 LENHART RD
Mailing Address - Street 2:LIVING HOPE COUNSELING CENTER
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62711-9203
Mailing Address - Country:US
Mailing Address - Phone:217-698-7150
Mailing Address - Fax:217-698-7085
Practice Address - Street 1:3000 LENHART RD
Practice Address - Street 2:LIVING HOPE COUNSELING CENTER
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62711-9203
Practice Address - Country:US
Practice Address - Phone:217-698-7150
Practice Address - Fax:217-698-7085
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007801101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health