Provider Demographics
NPI:1336519206
Name:SHANON HARLOW, LLC
Entity Type:Organization
Organization Name:SHANON HARLOW, LLC
Other - Org Name:UNDERSTANDING MINDS PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANON
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:314-729-1200
Mailing Address - Street 1:11144 TESSON FERRY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-6965
Mailing Address - Country:US
Mailing Address - Phone:314-729-1200
Mailing Address - Fax:314-729-1201
Practice Address - Street 1:11144 TESSON FERRY RD STE 101
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-6965
Practice Address - Country:US
Practice Address - Phone:314-729-1200
Practice Address - Fax:314-729-1201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-04
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 103TC0700X, 1041C0700X, 106H00000X
MO2007028046103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1730375759Medicaid
MOMA1352OtherPTAN