Provider Demographics
NPI:1295505642
Name:SHANNON LYNN THERAPY LLC
Entity type:Organization
Organization Name:SHANNON LYNN THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:240-347-2953
Mailing Address - Street 1:312 WESTSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-4556
Mailing Address - Country:US
Mailing Address - Phone:240-347-2953
Mailing Address - Fax:
Practice Address - Street 1:13327 WISDOM WAY
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-1513
Practice Address - Country:US
Practice Address - Phone:240-347-2953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty