Provider Demographics
NPI:1952492696
Name:HILLIER, SHANNON MARIE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:MARIE
Last Name:HILLIER
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 1:1611 S UTICA AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4909
Mailing Address - Country:US
Mailing Address - Phone:918-809-0351
Mailing Address - Fax:918-582-7348
Practice Address - Street 1:3701 S HARVARD AVE STE A
Practice Address - Street 2:BOX 143
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2282
Practice Address - Country:US
Practice Address - Phone:918-809-0351
Practice Address - Fax:918-582-7348
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1106101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor