Provider Demographics
NPI:1083278113
Name:WINTON, SHAWN (LPC/MHSP)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:WINTON
Suffix:
Gender:M
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 CICERO TRL
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1305
Mailing Address - Country:US
Mailing Address - Phone:423-580-5746
Mailing Address - Fax:
Practice Address - Street 1:8202 CICERO TRL
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1305
Practice Address - Country:US
Practice Address - Phone:423-580-5746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3983101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional