Healthcare Provider Details

I. General information

NPI: 1154038271
Provider Name (Legal Business Name): SHANEN NORLIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 W ENCANTO BLVD UNIT 110
PHOENIX AZ
85003-1193
US

IV. Provider business mailing address

16 W ENCANTO BLVD UNIT 110
PHOENIX AZ
85003-1193
US

V. Phone/Fax

Practice location:
  • Phone: 480-253-9762
  • Fax:
Mailing address:
  • Phone: 480-253-9762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-23215
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: