Provider Demographics
NPI:1952735797
Name:STEPHENS, LASHANNA SHAREE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LASHANNA
Middle Name:SHAREE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26964
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31221-6964
Mailing Address - Country:US
Mailing Address - Phone:478-216-7533
Mailing Address - Fax:
Practice Address - Street 1:640 PLUM ST STE 102
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2858
Practice Address - Country:US
Practice Address - Phone:478-216-7533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006455101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional