Provider Demographics
NPI:1831520105
Name:LANDHERR, SHANE (LMFT)
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:
Last Name:LANDHERR
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W HIGH ST
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-1351
Mailing Address - Country:US
Mailing Address - Phone:814-531-5659
Mailing Address - Fax:
Practice Address - Street 1:221 W HIGH ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-1351
Practice Address - Country:US
Practice Address - Phone:814-531-5659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000871106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist