Provider Demographics
NPI:1174313464
Name:SHINN, LAUREN (APC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SHINN
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2547 BRETON CT
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-2096
Mailing Address - Country:US
Mailing Address - Phone:678-920-9572
Mailing Address - Fax:
Practice Address - Street 1:4330 S LEE ST STE 800A
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-5797
Practice Address - Country:US
Practice Address - Phone:406-567-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC010019101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional