Provider Demographics
NPI:1922840487
Name:SCHWARZ, SHANNA (LPC)
Entity type:Individual
Prefix:
First Name:SHANNA
Middle Name:
Last Name:SCHWARZ
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 1:1577 WOODLAWN WAY
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-9572
Mailing Address - Country:US
Mailing Address - Phone:303-434-4092
Mailing Address - Fax:
Practice Address - Street 1:1577 WOODLAWN WAY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-9572
Practice Address - Country:US
Practice Address - Phone:303-434-4092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006301101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional