Provider Demographics
NPI:1477989242
Name:LINDSAY, SHANNA L (LPC)
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:L
Last Name:LINDSAY
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 1:518 E IDAHO ST
Mailing Address - Street 2:
Mailing Address - City:PAUL
Mailing Address - State:ID
Mailing Address - Zip Code:83347-5505
Mailing Address - Country:US
Mailing Address - Phone:208-670-0156
Mailing Address - Fax:
Practice Address - Street 1:518 E IDAHO ST
Practice Address - Street 2:
Practice Address - City:PAUL
Practice Address - State:ID
Practice Address - Zip Code:83347-5505
Practice Address - Country:US
Practice Address - Phone:208-670-0156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC4796101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional