Healthcare Provider Details

I. General information

NPI: 1780421602
Provider Name (Legal Business Name): SHAWNESE WARREN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2024
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 HAMPSTEAD HIGH ST STE 200
MONTGOMERY AL
36116-6789
US

IV. Provider business mailing address

5151 HAMPSTEAD HIGH ST STE 200
MONTGOMERY AL
36116-6789
US

V. Phone/Fax

Practice location:
  • Phone: 334-647-1047
  • Fax: 256-719-3252
Mailing address:
  • Phone: 334-647-1047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC06033
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLPC06033
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC06033
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: