Provider Demographics
NPI:1164600789
Name:HARTING, SHANNON LENYSE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:LENYSE
Last Name:HARTING
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:SHANNON
Other - Middle Name:LENYSE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10950 SCHUETZ RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5704
Mailing Address - Country:US
Mailing Address - Phone:314-993-1000
Mailing Address - Fax:314-812-9305
Practice Address - Street 1:10950 SCHUETZ RD
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5704
Practice Address - Country:US
Practice Address - Phone:314-993-1000
Practice Address - Fax:314-812-9305
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060353781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical