Provider Demographics
NPI:1134839673
Name:LYMAN, SHAWN DAVID (LAMFT)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:DAVID
Last Name:LYMAN
Suffix:
Gender:M
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 W MAIN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-2551
Mailing Address - Country:US
Mailing Address - Phone:479-595-0333
Mailing Address - Fax:888-816-7916
Practice Address - Street 1:2621 W MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-2551
Practice Address - Country:US
Practice Address - Phone:479-595-0333
Practice Address - Fax:888-816-7916
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARF2211001106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty