Provider Demographics
NPI:1073958179
Name:SITTER, SHANNON KAY (MA LCPC)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:KAY
Last Name:SITTER
Suffix:
Gender:F
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 CLEARFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN UNIVERSITY
Mailing Address - State:PA
Mailing Address - Zip Code:19352-9007
Mailing Address - Country:US
Mailing Address - Phone:215-480-2684
Mailing Address - Fax:
Practice Address - Street 1:330 CLEARFIELD DR
Practice Address - Street 2:
Practice Address - City:LINCOLN UNIVERSITY
Practice Address - State:PA
Practice Address - Zip Code:19352-9007
Practice Address - Country:US
Practice Address - Phone:215-480-2684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5056101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional