Provider Demographics
NPI:1700206968
Name:LAWSON, SHANA R (LPCA)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:R
Last Name:LAWSON
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GENE CASH RD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-4908
Mailing Address - Country:US
Mailing Address - Phone:270-465-7768
Mailing Address - Fax:270-465-0068
Practice Address - Street 1:50 GENE CASH RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-4908
Practice Address - Country:US
Practice Address - Phone:270-465-7768
Practice Address - Fax:270-465-0068
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-25
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1484101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional