Provider Demographics
NPI:1093602013
Name:COLLISON, SHAUNA (LPC)
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:COLLISON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 WESTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2426
Mailing Address - Country:US
Mailing Address - Phone:314-706-0173
Mailing Address - Fax:
Practice Address - Street 1:41 WESTWOOD CT
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2426
Practice Address - Country:US
Practice Address - Phone:314-706-0173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022049328101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional