Provider Demographics
NPI:1023605847
Name:KRAMER, SHANNON DEE (LPC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:DEE
Last Name:KRAMER
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 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:125 SCHNEIDER DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17046-4875
Practice Address - Country:US
Practice Address - Phone:717-270-2444
Practice Address - Fax:717-270-2472
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012908101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC012908OtherSTATE LICENSE
PA103909754Medicaid
15077807OtherCAQH