Provider Demographics
NPI:1750721411
Name:SHANNON CRANSTON PLLC
Entity type:Organization
Organization Name:SHANNON CRANSTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CRANSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:810-516-7251
Mailing Address - Street 1:1286 S LINDEN RD STE B
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3457
Mailing Address - Country:US
Mailing Address - Phone:810-407-7403
Mailing Address - Fax:888-478-2380
Practice Address - Street 1:1286 S LINDEN RD STE B
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3457
Practice Address - Country:US
Practice Address - Phone:810-407-7403
Practice Address - Fax:884-782-3808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014638103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty