Provider Demographics
NPI:1073375036
Name:SHONKWILER, SUZANNE (LMHCA)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:SHONKWILER
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 E MAIN ST STE 216
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-5541
Mailing Address - Country:US
Mailing Address - Phone:317-649-4311
Mailing Address - Fax:
Practice Address - Street 1:18 E MAIN ST STE 216
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-5541
Practice Address - Country:US
Practice Address - Phone:317-649-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88002090A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health