Provider Demographics
NPI:1376218537
Name:ADEDOKUN, SHANON (LPC)
Entity Type:Individual
Prefix:
First Name:SHANON
Middle Name:
Last Name:ADEDOKUN
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 1:1331 OLD OAK PLACE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-8485
Mailing Address - Country:US
Mailing Address - Phone:334-409-9242
Mailing Address - Fax:334-409-9186
Practice Address - Street 1:1331 OLD OAK PLACE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-8485
Practice Address - Country:US
Practice Address - Phone:334-409-9242
Practice Address - Fax:334-409-9186
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4402101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional