Provider Demographics
NPI:1205018249
Name:LENNARTSON, SHAWN A (LPC)
Entity Type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:A
Last Name:LENNARTSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 RAWHIDE DR
Mailing Address - Street 2:206
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-6957
Mailing Address - Country:US
Mailing Address - Phone:512-388-3638
Mailing Address - Fax:512-388-3634
Practice Address - Street 1:1970 RAWHIDE DR
Practice Address - Street 2:206
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-6957
Practice Address - Country:US
Practice Address - Phone:512-388-3638
Practice Address - Fax:512-388-3634
Is Sole Proprietor?:No
Enumeration Date:2007-12-01
Last Update Date:2007-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60853101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional