Provider Demographics
NPI:1932304508
Name:HORTON, SHANNON M (LCMFT)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:M
Last Name:HORTON
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-6110
Mailing Address - Country:US
Mailing Address - Phone:785-539-1017
Mailing Address - Fax:785-539-3097
Practice Address - Street 1:1558 HAYES DR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5068
Practice Address - Country:US
Practice Address - Phone:785-539-1017
Practice Address - Fax:785-539-3097
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS913106H00000X
KS778106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist