Provider Demographics
NPI:1184498073
Name:HAUS, SHANNON LEWIS (LMHC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:LEWIS
Last Name:HAUS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12318 NE 22ND ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-9196
Mailing Address - Country:US
Mailing Address - Phone:515-954-6886
Mailing Address - Fax:
Practice Address - Street 1:1605 N ANKENY BLVD STE 110
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4163
Practice Address - Country:US
Practice Address - Phone:515-316-5594
Practice Address - Fax:515-532-5401
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-10
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA113049101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health