Provider Demographics
NPI:1881232841
Name:SCANNELL, KATELYNN E (LPC)
Entity Type:Individual
Prefix:
First Name:KATELYNN
Middle Name:E
Last Name:SCANNELL
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 1:334 TOUCHDOWN DR
Mailing Address - Street 2:
Mailing Address - City:FORISTELL
Mailing Address - State:MO
Mailing Address - Zip Code:63348-2656
Mailing Address - Country:US
Mailing Address - Phone:636-544-0780
Mailing Address - Fax:
Practice Address - Street 1:334 TOUCHDOWN DR
Practice Address - Street 2:
Practice Address - City:FORISTELL
Practice Address - State:MO
Practice Address - Zip Code:63348-2656
Practice Address - Country:US
Practice Address - Phone:636-544-0780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-20
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020003306101YM0800X
101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty