Healthcare Provider Details

I. General information

NPI: 1902570674
Provider Name (Legal Business Name): SHAYNA MICHAEL DUNN LCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SOUTHWIND PL STE 201
MANHATTAN KS
66503-3186
US

IV. Provider business mailing address

200 SOUTHWIND PL STE 201
MANHATTAN KS
66503-3186
US

V. Phone/Fax

Practice location:
  • Phone: 785-377-5847
  • Fax: 785-367-9876
Mailing address:
  • Phone: 785-377-5847
  • Fax: 785-367-9876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39005967A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLCP01567
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: