Provider Demographics
NPI:1265007140
Name:SHANNON NOON, LCPC, LLC
Entity Type:Organization
Organization Name:SHANNON NOON, LCPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PROFESSIONAL COUN
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:NOON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-532-1573
Mailing Address - Street 1:1515 FAIRVIEW AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-7821
Mailing Address - Country:US
Mailing Address - Phone:406-532-1573
Mailing Address - Fax:406-532-1541
Practice Address - Street 1:1515 FAIRVIEW AVE STE 235
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7821
Practice Address - Country:US
Practice Address - Phone:406-532-1573
Practice Address - Fax:406-532-1541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty