Provider Demographics
NPI:1700091006
Name:CROSSLER, SHANNON LEE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:LEE
Last Name:CROSSLER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 40TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-6809
Mailing Address - Country:US
Mailing Address - Phone:406-272-6490
Mailing Address - Fax:
Practice Address - Street 1:220 3RD AVE STE 407
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3554
Practice Address - Country:US
Practice Address - Phone:406-272-6490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2020-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT907101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional