Provider Demographics
NPI:1629371836
Name:HEBERT, SHAWN LYNN (LPCC)
Entity Type:Individual
Prefix:MS
First Name:SHAWN
Middle Name:LYNN
Last Name:HEBERT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 FLORIDA AVE S
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1719
Mailing Address - Country:US
Mailing Address - Phone:952-544-6806
Mailing Address - Fax:
Practice Address - Street 1:3033 EXCELSIOR BLVD STE 465
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-3372
Practice Address - Country:US
Practice Address - Phone:612-465-9948
Practice Address - Fax:612-486-8800
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00180101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional