Provider Demographics
NPI:1467077164
Name:HORAN, SHANNA (LMHC)
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:
Last Name:HORAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 N HIGHWAY 183 STE 335
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-7016
Mailing Address - Country:US
Mailing Address - Phone:904-878-7317
Mailing Address - Fax:
Practice Address - Street 1:651 N HIGHWAY 183 # 335-3050
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-7001
Practice Address - Country:US
Practice Address - Phone:904-878-7317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15146101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health