Provider Demographics
NPI:1336329176
Name:WARDEN, SHANNON DENNEY (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:DENNEY
Last Name:WARDEN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 ADMIRAL RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2810
Mailing Address - Country:US
Mailing Address - Phone:865-966-5224
Mailing Address - Fax:
Practice Address - Street 1:138 ADMIRAL RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2810
Practice Address - Country:US
Practice Address - Phone:865-966-5224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN668106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist