Healthcare Provider Details

I. General information

NPI: 1679424501
Provider Name (Legal Business Name): SHAWNEE TRAINOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 FALLS CT APT A
LANSING MI
48917-1937
US

IV. Provider business mailing address

225 FALLS CT APT A
LANSING MI
48917-1937
US

V. Phone/Fax

Practice location:
  • Phone: 502-975-9290
  • Fax:
Mailing address:
  • Phone: 502-975-9290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: