Provider Demographics
NPI:1811057789
Name:BLACKBURN, SHAWNE ANN (LPCC)
Entity type:Individual
Prefix:MS
First Name:SHAWNE
Middle Name:ANN
Last Name:BLACKBURN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5916 ANAHEIM AVE NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1894
Mailing Address - Country:US
Mailing Address - Phone:505-291-6314
Mailing Address - Fax:505-275-0296
Practice Address - Street 1:5916 ANAHEIM AVE NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1894
Practice Address - Country:US
Practice Address - Phone:505-291-6314
Practice Address - Fax:505-275-0296
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional